CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION (EIN 91-0171250)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-30
IRS object ID
201243049349301404
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-10-30T16:07:24-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 22650AddressLine1
CityYAKIMACity
StateWAState
ZIP Code989072650ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN910171250EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCENTNameControl
Phone5096621515Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1887AddressLine1
CityWENATCHEECity
StateWAState
ZIP Code988071887ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN B HAMILTONName
TitleINTERIM CEO & EVP & COOTitle
Phone5096621515Phone
Date Signed2012-10-17DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCHRISTOPHER E RIVARDName
PTINP00022321PTIN
Phone5092487750Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CENTRAL WASHINGTON HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN B HAMILTONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1887AddressLine1
CityWENATCHEECity
StateWAState
ZIP Code988071887ZIPCode
FieldValueIRS element (for citing)
Gross Receipts212912210GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CWHS.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionA PROVIDER OF HEALTH CARE SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1560TotalNbrEmployees
Total Nbr Volunteers175TotalNbrVolunteers
Total Gross UBI387623TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1200474ContributionsGrantsPriorYear
Contributions Grants Current Year1902958ContributionsGrantsCurrentYear
Program Service Revenue Prior Year181613747ProgramServiceRevenuePriorYear
Program Service Revenue CY179550355ProgramServiceRevenueCY
Investment Income Prior Year2993079InvestmentIncomePriorYear
Investment Income Current Year2536774InvestmentIncomeCurrentYear
Other Revenue Prior Year1130419OtherRevenuePriorYear
Other Revenue Current Year1427364OtherRevenueCurrentYear
Total Revenue Prior Year186937719TotalRevenuePriorYear
Total Revenue Current Year185417451TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year101208154SalariesEtcPriorYear
Salaries Etc Current Year104255208SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year1600TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY106879TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year126483TotalFundrsngExpCurrentYear
Other Expense Prior Year80985943OtherExpensePriorYear
Other Expenses Current Year86252044OtherExpensesCurrentYear
Total Expenses Prior Year182195697TotalExpensesPriorYear
Total Expenses Current Year190614131TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4742022RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-5196680RevenuesLessExpensesCY
Total Assets BOY312497943TotalAssetsBOY
Total Assets EOY296249714TotalAssetsEOY
Total Liabilities BOY147355742TotalLiabilitiesBOY
Total Liabilities EOY138964940TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY165142201NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY157284774NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIN ITS TRADITION OF SERVICE, CENTRAL WASHINGTON HOSPITAL RESPONDS TO COMMUNITY NEEDS BY PROVIDING QUALITY HEALTHCARE THROUGH CARING, COMPETENCE AND ACCOUNTABILITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense123256494Expense
Revenue178805187Revenue
DescriptionCENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION (CWHSA) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF CWHSA, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND, FURTHER, THAT OUR MISSION IS TO SERVICE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVICE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE; CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUALS' INABILITY TO PAY CO-EXISTS. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. CWHSA SERVICED 9,160 IN-PATIENTS AND PROVIDED MORE THAN 32,569 DAYS OF CARE DURING 2011.CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES WHICH CWHSA BELIEVES WILL SERVICE A BONA FIDE COMMUNITY HEALTH NEED. THESE ACTIVITIES AND SERVICES ARE INCLUDED IN THE FOLLOWING PAGES.Description
Total Program Service Expense123256494TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096107NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1560NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSTEVE JACOBSNamePerson
Telephone Number5096621515TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11201 SOUTH MILLER STAddressLine1
CityWENATCHEECity
StateWAState
ZIP Code98801ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
DAVID W PARKS DMD
CHAIR2.00XX18400
STEPHEN F VOORHIES MD
CHIEF OF STAFF2.00XX76400
MARC C HEMINGER
MEMBER1.00X000
FRANK J KUNTZ
MEMBER1.00X9200
BEVERLY A JAGLA
MEMBER1.00X67200
SI BAUTISTA
MEMBER1.00X76400
PHILLIP R JOHNSON
MEMBER1.00X9200
JOHN W GILL MD
BOARD SECRETARY2.00XX9200
LINDA K SCHATZ MD
MEMBER1.00X9200
GARY K LAMMERT MD
MEMBER1.00X000
KRISTINE LOOMIS
BOARD TREASURER2.00XX000
LAURA MOUNTER
MEMBER1.00X9200
KENNETH J MARTIN
VICE CHAIR2.00XX76400
JOHN T EVANS JR
PRESIDENT/CEO40.00X4152910121921
STEVEN R JACOBS
VICE PRESIDENT/CFO40.00X261492078154
JOHN B HAMILTON
VICE PRESIDENT/COO40.00X277534080660
TRACEY A KASNIC
VICE PRESIDENT/PATIENT CARE SE40.00X210870038398
MARK A BROBERG
PHYSICIAN40.00680780034043X
R CRAIG BROWNLEE
PHYSICIAN40.00417163029167X
HANK J VEJVODA
PHYSICIAN40.00634565036083X
LINDA L STRAND
PHYSICIAN40.00272942035579X
SAMUEL M ORTIZ
PHYSICIAN40.00284260033302X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3458505TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation487307TotalOtherCompensation
Number Individuals GT100 K72NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WENATCHEE EMERGENCY PHYSICIANS
1201 S MILLER STWENATCHEEWA98801EMERGENCY PHYSICIAN SERVICES2737337
WENATCHEE VALLEY MEDICAL CT
820 N CHELAN AVEWENATCHEEWA98801PHYSICIAN SERVICES2163988
EBMS
2075 OVERLAND AVEBILLINGSMT59102MEDICAL CLAIMS ADMINISTRATION760509
WENATCHEE ANESTHESIA ASSOC
19 S BUCHANAN AVEWENATCHEEWA98801PHYSICIAN SERVICES687697
HEALTHCARE PERFORMANCE GROUP
23419 WEST 215TH STSPRING HILLKS66083CONSULTING636907
FieldValueIRS element (for citing)
Number Of Contractors GT100 K31NumberOfContractorsGT100K
Government Grants1690459GovernmentGrants
All Other Contributions212499AllOtherContributions
Noncash Contributions21405NoncashContributions
Total Contributions1902958TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER PROFESSIONAL SER6241008862315688623156
OTHER NURSING SERVICES6241003855300838553008
DAILY PATIENT SERVICES6241003389618533896185
PHYSICIAN SERVICES6241001034871710348717
HOME HEALTH, HOSPICE,62410064698946469894

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column1659395TotalRevenueColumn
Related Or Exempt Function Income774RelatedOrExemptFunctionIncome
Unrelated Business Revenue299499UnrelatedBusinessRevenue
Exclusion$1,359,122ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue179550355TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16052TotalRevenueColumn
Exclusion$16,052ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1367953Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real979485Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real388468Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column388468TotalRevenueColumn
Exclusion$388,468ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities29035996Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities26515274Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2520722Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2520722TotalRevenueColumn
Exclusion$2,520,722ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
MISCELLANEOUS900099871743871743
INCOME FROM K-19000991245673644388124
PURCHASE DISCOUNTS900099425865267$37,319
FieldValueIRS element (for citing)
Total Other Revenue1038896TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column185417451TotalRevenueColumn
Related Or Exempt Function Income178805187RelatedOrExemptFunctionIncome
Unrelated Business Revenue387623UnrelatedBusinessRevenue
Exclusion$4,321,683ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1487928Total
Management And General1487928ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total82002831Total
Program Services60613542ProgramServices
Management And General21389289ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4329697Total
Program Services3386434ProgramServices
Management And General943263ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8876872Total
Program Services5840208ProgramServices
Management And General3036664ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7557880Total
Program Services4502858ProgramServices
Management And General3055022ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total599675Total
Management And General599675ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total117060Total
Management And General117060ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total106879Total
Fundraising106879Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total63151Total
Management And General63151ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9318111Total
Program Services5259103ProgramServices
Management And General4059008ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total236948Total
Program Services90861ProgramServices
Management And General133292ManagementAndGeneral
Fundraising12795Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9765357Total
Program Services4584847ProgramServices
Management And General5173701ManagementAndGeneral
Fundraising6809Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1891749Total
Program Services80926ProgramServices
Management And General1810823ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total610552Total
Program Services271241ProgramServices
Management And General339311ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5329958Total
Management And General5329958ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13171774Total
Program Services3782054ProgramServices
Management And General9389720ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2070788Total
Program Services299200ProgramServices
Management And General1771588ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES34131205326310421500163
LICENSES AND TAXES450943313814508052
OTHER PURCHASED SERVICE354275817017071841051
DUES AND SUBSCRIPTIONS453957157080296877

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total439568Total
Program Services54010ProgramServices
Management And General385558ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total190614131Total
Program Services123256494ProgramServices
Management And General67231154ManagementAndGeneral
Fundraising126483Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2825028BOY
EOY417987EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14220890BOY
EOY2827490EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY6430202BOY
EOY3794812EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY30996239BOY
EOY31051200EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5741113BOY
EOY5871316EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3680858BOY
EOY3529988EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis292765769LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec116303490LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY165154110BOY
EOY176462279EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY77835081BOY
EOY66083630EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5614422BOY
EOY6211012EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY312497943BOY
EOY296249714EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY30315449BOY
EOY21979163EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY114825000BOY
EOY113915000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2215293BOY
EOY3070777EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY147355742BOY
EOY138964940EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY158711999BOY
EOY153489962EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6430202BOY
EOY3794812EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY165142201BOY
EOY157284774EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY312497943BOY
EOY296249714EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-5196680ReconcilationRevenueExpenses
Reconcilation Other Changes-2660747ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$34,144DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB34144TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationWA STATE HOSPITAL ASSOCIATION DUES - 21.60% OF $122,075 = $26,368 AMERICAN HOSPITAL ASSOCIATION DUES - 24.60% OF $31,609 =$7,776 TOTAL $34,144Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8981311OtherCostOrOtherBasis
Book Value8981311BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis94618952OtherCostOrOtherBasis
Depreciation17117540Depreciation
Book Value77501412BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis24934447OtherCostOrOtherBasis
Depreciation14696412Depreciation
Book Value10238035BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis162189013OtherCostOrOtherBasis
Depreciation84489538Depreciation
Book Value77699475BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2042046OtherCostOrOtherBasis
Book Value2042046BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings176462279TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
RESERVE FOR MALPRACTICE INSURANCE CLAIMS$2,824,000
DOUGLAS COUNTY WATER ASSESSMENT DEBT$246,777
FieldValueIRS element (for citing)
Total Of Amounts3070777TotalOfAmounts
Total Revenue185417451TotalRevenue
Total Expenses190614131TotalExpenses
Excess Or Deficit For Year-5196680ExcessOrDeficitForYear
Net Unrealized GL On Investments-2536179NetUnrealizedGLOnInvestments
Other-$124,568OtherAmount
Total Adjustments-2660747TotalAdjustments
Excess Or Deficit Per FS-7857427ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt182481258TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-2536179NetUnrealizedGainsInvestments
Revenue Not Rptd F990-2536179RevenueNotRptdF990
Revenue Subtotal185017437RevenueSubtotal
Investment Expenses Not Included63151InvestmentExpensesNotIncluded
Other Revenues Not Included336863OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt400014RevenueNotRptdOnFinStmt
Total Revenue Per Form990185417451TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt190338686TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal190338686ExpensesSubtotal
Investment Expenses Not Included263151InvestmentExpensesNotIncluded2
Other Expenses Not Included212294OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt275445ExpensesNotRptdOnFinStmt
Total Expenses Per Form990190614131TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:EFFECTIVE JANUARY 1, 2009, THE ASSOCIATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF DECEMBER 31, 2011 AND 2010, THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL.
PART XI, LINE 8 - OTHER ADJUSTMENTS:ROUNDING -1. INCOME ON K-1 NOT INCLUDED IN REVENUE ON FINANCIAL STATEMENT -124,567. TOTAL TO SCHEDULE D, PART XI, LINE 8: -124,568.
PART XII, LINE 4B - OTHER ADJUSTMENTS:SALARY, BENEFITS AND OTHER OPERATING EXP. INCLUDED IN REVENUE ON FORM 990 -35,871. INCOME ON K-1 NOT INCLUDED IN REVENUE ON FINANCIAL STATEMENT 124,567. SALARY, BENEFITS AND OTHER NON-OPER. EXP. INCLUDED IN REVENUE ON FORM 990 121,682. FUNDRAISING EXPENSE NOT INCLUDED IN REVENUE ON FORM 990 126,483. ROUNDING 2.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:SALARY, BENEFITS AND OTHER OPERATING EXP. INCLUDED IN REVENUE ON FORM 990 -35,871. SALARY, BENEFITS AND OTHER NON-OPER. EXP. INCLUDED IN REVENUE ON FORM 990 121,682. FUNDRAISING EXPENSE NOT INCLUDED IN REVENUE ON FORM 990 126,483.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Agreement Ref Fundraising0AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeActivityActivityFundraiser Control Of FundsFundraiserControlOfFundsGross ReceiptsGrossReceiptsAmount Retained By ContractorAmountRetainedByContractorNet To OrganizationNetToOrganization
CAPITAL QUEST
4662 GRAVELLY HILLS ROADLOUISVILLETN37777CAPITAL CAMPAIGN0042400-42400
RUSS REID CO
2000 L STREET NW SUITE 350WASHINGTON DCDC20036CAPITAL CAMPAIGN0064479-64479
FieldValueIRS element (for citing)
Total Retained By Contractors106879TotalRetainedByContractors
Total Net To Organization-106879TotalNetToOrganization

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage175.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6019958TotalCommunityBenefitExpense
Net Community Benefit Expense6019958NetCommunityBenefitExpense
Percent Of Total Expense0.03160PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense31493228TotalCommunityBenefitExpense
Direct Offsetting Revenue19472934DirectOffsettingRevenue
Net Community Benefit Expense12020294NetCommunityBenefitExpense
Percent Of Total Expense0.06310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense37513186TotalCommunityBenefitExpense
Direct Offsetting Revenue19472934DirectOffsettingRevenue
Net Community Benefit Expense18040252NetCommunityBenefitExpense
Percent Of Total Expense0.09470PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served391PersonsServed
Total Community Benefit Expense16587TotalCommunityBenefitExpense
Net Community Benefit Expense16587NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served524PersonsServed
Total Community Benefit Expense1379952TotalCommunityBenefitExpense
Net Community Benefit Expense1379952NetCommunityBenefitExpense
Percent Of Total Expense0.00720PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense59432TotalCommunityBenefitExpense
Net Community Benefit Expense59432NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served915PersonsServed
Total Community Benefit Expense1455971TotalCommunityBenefitExpense
Net Community Benefit Expense1455971NetCommunityBenefitExpense
Percent Of Total Expense0.00760PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served915PersonsServed
Total Community Benefit Expense38969157TotalCommunityBenefitExpense
Direct Offsetting Revenue19472934DirectOffsettingRevenue
Net Community Benefit Expense19496223NetCommunityBenefitExpense
Percent Of Total Expense0.10230PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$6,745,902BadDebtExpenseAmount
Amount Reimbursed By Medicare77919824AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare80184348CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2264524MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CENTRAL WASHINGTON HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO BOX 1887AddressLine1
CityWENATCHEECity
StateWAState
ZIP Code98807ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL WASHINGTON HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent175.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: GROSS CHARGES WRITTEN OFF TO BAD DEBT AFTER PAYMENTS, CONTRACTUAL ADJUSTMENTS, AND CHARITY.
PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE ASSOCIATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ASSOCIATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ASSOCIATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ASSOCIATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS CHANGED FROM 55% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2010, TO 64% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2011. IN ADDITION, THE ASSOCIATION'S SELF-PAY WRITE-OFFS CHANGED $254,000, FROM $6,351,000 FOR FISCAL YEAR 2010 TO $6,605,000 FOR FISCAL YEAR 2011. THE ASSOCIATION HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2011 OR 2010.
PART III, LINE 8: THE HOSPITAL PROVIDES CARE TO INDIVIDUALS COVERED BY THE MEDICARE AND MEDICAID PROGRAMS IN SPITE OF THE FACT THAT THE COST OF PROVIDING THOSE SERVICES OFTEN EXCEEDS THE REVENUE RECEIVED. THIS IS A CONTINUED COMMITMENT TO PROVIDING QUALITY HEALTHCARE SERVICES AND PROMOTING HEALTH IMPROVEMENT TO ALL PERSONS IN ITS SERVICE AREA WITHOUT REGARD TO ABILITY TO PAY. THE HOSPITAL QUALIFIES FOR THE MEDICARE DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAM BASED ON THE HIGH NUMBER OF INDIGENT PATIENTS WHO RECEIVE CARE.
PART III, LINE 9B: COLLECTION IS SUSPENDED WHEN THE COMPLETED UNCOMPENSATED CARE APPLICATION AND SUPPORTING FINANCIAL DOCUMENTATION IS RECEIVED. COLLECTION REMAINS SUSPENDED UNTIL FINAL DETERMINATION OF QUALIFICATION FOR ASSISTANCE IS COMPLETED.
PART V, SECTION B, LINE 19D: SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES.CENTRAL WASHINGTON HOSPITAL
PART VI, LINE 2: CURRENTLY CENTRAL WASHINGTON HOSPITAL DOES NOT HAVE AN ASSESSMENT PROGRAM TO EVALUATE THE HEALTH CARE NEEDS OF THE COMMUNITY. CENTRAL WASHINGTON HOSPITAL'S PROGRAM IS BASED ON HISTORICAL ACTIVITIES AND RESPONDING TO SPECIFIC REQUESTS.
PART VI, LINE 3: THE HOSPITAL'S CHARITY CARE POLICY IS MADE PUBLICLY AVAILABLE THROUGH THE FOLLOWING ELEMENTS:A. A NOTICE ADVISING PATIENTS THAT THE HOSPITAL PROVIDES CHARITY CARE WILL BE POSTED IN KEY AREAS OF THE HOSPITAL, INCLUDING ADMISSIONS, THE EMERGENCY DEPARTMENT, AND CASHIER OFFICE.B. THE HOSPITAL WILL INCLUDE A WRITTEN NOTICE EXPLAINING THE POLICY TO PATIENTS AT THE TIME THAT THE HOSPITAL SUBMITS BILLING TO THE PATIENT OR RESPONSIBLE PARTY (HEREAFTER REFERRED TO AS 'GUARANTOR').C. THE WRITTEN INFORMATION WILL BE AVAILABLE IN ANY LANGUAGE SPOKEN BY MORE THAN TEN PERCENT OF THE POPULATION IN THE HOSPITAL'S SERVICE AREA. INTERPRETIVE SERVICES WILL BE PROVIDED FOR OTHER NON-ENGLISH SPEAKING OR LIMITED-ENGLISH SPEAKING PATIENTS. INTERPRETIVE SERVICES WILL ALSO BE PROVIDED FOR PATIENTS WHO CANNOT UNDERSTAND THE WRITING AND/OR EXPLANATION.D. THE HOSPITAL WILL TRAIN ADMITTING AND PATIENT ACCOUNTS STAFF TO ANSWER CHARITY CARE QUESTIONS EFFECTIVELY.E. WRITTEN INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE POLICY WILL BE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION IN PERSON, VIA PHONE, OR BY LETTER. THE HOSPITAL'S CHARITY DISCOUNT TABLE WILL ALSO BE MADE AVAILABLE UPON REQUEST.
PART VI, LINE 4: CENTRAL WASHINGTON HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS AND OPERATES A LICENSED 198-BED ACUTE CARE HOSPITAL DELIVERING A FULL RANGE OF HEALTH CARE SERVICES IN WENATCHEE, WASHINGTON AND THE NORTH CENTRAL WASHINGTON AREA. THE MAJORITY OF PATIENTS COME FROM CHELAN, DOUGLAS, GRANT AND OKANOGAN COUNTIES. 71% OF THE HOSPITAL'S PATIENTS ARE MEDICARE/MEDICAID ELIGIBLE.
PART VI, LINE 5: CENTRAL WA HOSPITAL'S GOVERNING BOARD IS COMPRISED OF LOCAL AREA RESIDENTS. THE HOSPITAL EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. CWH USES ITS INCOME TO UPDATE EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. THE HOSPITAL OFFERS EDUCATION FOR AREA PHYSICIANS AND COMMUNITY MEMBERS. ALSO AVAILABLE TO PHYSICIANS AND THE COMMUNITY IS THE HEMINGER HEALTH LIBRARY. WE COLLABORATE WITH MANY LOCAL AND STATE COLLEGES, UNIVERSITIES, AND OUR LOCAL HIGH SCHOOL IN SUPPORT OF STUDENT LEARNING OPPORTUNITIES. IN 2010 AN ELECTRONIC MEDICAL RECORD WAS IMPLEMENTED. THE SYSTEM GIVES OUR PROVIDERS ALL THE MEDICAL INFORMATION NEEDED TO MAKE THE BEST DECISIONS IN THE CARE OF OUR PATIENTS. THE HOSPITAL IS A FEDERAL REGIONAL REFERRAL CENTER AND A LEVEL III GENERAL AND PEDIATRIC TRAUMA CENTER. CENTRAL WASHINGTON HOSPITAL HAS BEEN NAMED TO THE COMMUNITY VALUE INDEX TOP 100 HOSPITALS LIST, IDENTIFYING CENTRAL AS A LEADER IN LOW-COST, LOW-CHARGE HOSPITAL CARE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN T EVANS JR
415291000001036540182670537212000
STEVEN R JACOBS
2614920000071026071280339646000
JOHN B HAMILTON
2775340000072117085430358194000
TRACEY A KASNIC
177040033830000155960228020249268000
MARK A BROBERG
68078000000159250181180714823000
R CRAIG BROWNLEE
41716300000159250132420446330000
HANK J VEJVODA
63456500000159250201580670648000
LINDA L STRAND
27294200000159250196540308521000
SAMUEL M ORTIZ
28426000000159250173770317562000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationPART I, LINE 4B: FORM 990, SCHEDULE J, PART I, LINE 4B: JOHN T. EVANS, JR: $85,279 JOHN B. HAMILTON: $54,967 STEVEN R. JACOBS: $50,201 THE VALUE IS BASED ON A PERCENTAGE OF THEIR INDIVIDUAL ANNUAL SALARY.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WASHINGTON HEALTH CARE FACILITIES AUTHORITY
91110892993978E4M12009-08-12114560771CONSTRUCTION OF HEALTHCARE FACILITY000
WASHINGTON HEALTH CARE FACILITIES AUTHORITY
91110892993978EQL92001-04-1019755081CONSTRUCTION OF HEALTHCARE FACILITY100

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
1653500011653500013772133766746721458738083454720110111
199950001815788620050011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000.000000.000000.000001
00000.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of GICTermOfGIC
1001100
100110020.000000000000

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, SCHEDULE K, PART IV, LINE 4B AND 4C, COLUMN A:NAME OF PROVIDER OF GIC, LINE 4B: 1. TRINITY FUNDING COMPANY 2. RBC CAPITAL MARKETS LINE 4C: 1. 14 MONTHS 2. 3 YEARS AND 5 YEARS
FORM 990, SCHEDULE K, PART IV, LINE 4B, COLUMN B:NAME OF PROVIDER OF GIC, LINE 4B: MBIA(SWITCHED TO BANK OF NEW YORK IN 2008)
FORM 990, SCHEDULE K, PART III, LINE 7, COLUMN A AND B:THE ORGANIZATION IS IN PROCESS OF ADOPTING POLICY RELATED TO ENSURING POST-ISSUANCE COMPLIANCE.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED. THE 990 IS REVIEWED BY THE DIRECTOR OF ACCOUNTING, AND THE CFO. A SUMMARY OF THE 990 IS PROVIDED TO THE FINANCE COMMITEE.
FORM 990, PART VI, SECTION B, LINE 12CALL BOARD MEMBERS, EMPLOYED PHYSICIANS, AND MEMBERS OF THE ADMINISTRATIVE TEAM ARE REQUIRED TO REVIEW THE CURRENT CONFLICT OF INTEREST POLICY AND COMPLETE AN ANNUAL QUESTIONNAIRE. THE NOMINATING COMMITTEE OF THE BOARD REVIEWS QUESTIONNAIRES SUBMITTED BY BOARD MEMBERS FOR POTENTIAL CONFLICTS OF INTEREST. POTENTIAL QUESTIONS OF CONFLICT FOR BOARD MEMBERS ARE RESOLVED BY THE NOMINATING COMMITTEE OF THE BOARD. THE HOSPITAL'S EXECUTIVE TEAM REVIEWS QUESTIONNAIRES SUBMITTED BY EMPLOYED PHYSICIANS AND THE ADMINISTRATIVE TEAM FOR POTENTIAL CONFLICTS OF INTEREST. POTENTIAL QUESTIONS OF CONFLICT FOR MEMBERS OF THE ADMINISTRATIVE TEAM ARE RESOLVED BY THE EXECUTIVE TEAM IN COLLABORATION WITH THE CORPORATE COMPLIANCE OFFICER. BOARD MINUTES REFLECT WHEN THE REVIEW IS COMPLETE.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS INDEPENDENT SALARY SURVEY INFORMATION AND RECOMMENDS A SALARY INCREASE FOR THE CEO TO THE FULL BOARD. THE OTHER OFFICERS RECEIVE THE ANNUAL PERCENT INCREASE WHICH OTHER NON-CONTRACTUAL EMPLOYEES RECEIVE UNLESS THE CEO AWARDS A DIFFERENT PERCENTAGE. THE AMOUNT IS BASED ON CURRENT CPI, MARKET, AND SALARY SURVEY INFORMATION.
FORM 990, PART VI, SECTION C, LINE 19CENTRAL WASHINGTON HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -2,536,179. ROUNDING -1. INCOME ON K-1 NOT INCLUDED IN REVENUE ON FINANCIAL STATEMENT -124,567. TOTAL TO FORM 990, PART XI, LINE 5: -2,660,747.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:NO CHANGE FROM PRIOR YEAR.

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