2011-09-15T16:39:17-05:00 2010-10-31 990 2009-11-01 910567263 YAKIMA VALLEY MEMORIAL HOSPITAL Assoc YAKI 5095758000 2811 TIETON DRIVE YAKIMA WA 98902 Richard W LINNEWEH 5095758000 2011-09-15 2009 2016-02-24 21:20:13Z Richard W LINNEWEH 2811 TIETON DRIVE YAKIMA WA 98902 326715290 0 X www.yakimamemorial.org X 1950 WA Yakima Valley Memorial Hospital's mission is to improve the health of those we serve. We have 226 inpatient beds and also provide numerous diagnostic and therapeutic services on an outpatient basis. 16 16 2664 640 32318184 -6337124 5165157 5913125 264807481 283040595 1320197 1074750 5011313 34702360 276304148 324730830 0 0 156598794 162310820 0 0 137760997 151514376 294359791 313825196 -18055643 10905634 235294150 256448195 140184935 142164788 95109215 114283407 Yakima Valley Memorial Hospital's mission is to improve the health of those we serve. We have 226 inpatient beds and also provide numerous diagnostic and therapeutic services on an outpatient basis. 0 0 115117899 127498411 Yakima Valley Memorial Hospital served 376,245 outpatient visits for various services including surgery, cancer care, diagnostic testing, and therapeutic services. Those outpatient services were offered in a manner consistent with the hospital's 501(c)(3) status. The intent of the services is to serve the health care needs of the community. Charity care is provided per the terms of the hospital's charity care policy. The hospital also provides numerous educational services for student physicians, nurses, and allied health care professionals. 90687473 127498411 Yakima Valley Memorial Hospital admitted 14,726 patients for a total of 55,517 patient days. Those inpatient services were offered in a manner consistent with the hospital's 501(c)(3) status. The intent of the services is to serve the health care needs of the community. Charity care is provided per the terms of the hospital's charity care policy. The hospital also provides numerous educational services for student physicians, nurses, and allied health care professionals. 10768472 16700 Yakima Valley Memorial Hospital provides direct supporting services to better assist in providing both inpatient and outpatient services, but not directly identifiable with either inpatient or outpatient services provided. Those services were offered in a manner consistent with the hospital's 501(c)(3) status. The intent of the services is to serve the health care needs of the community. Charity care is provided per the terms of the hospital's charity care policy. The hospital also provides numerous educational services for student physicians, nurses, and allied health care professionals. 3428818 1230110 Coordination of Children's Services, residency program, community education regarding health issues. 3428818 1230110 220002662 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 0 0 1 299 0 2664 1 1 1 0 0 0 0 0 0 0 0 16 16 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 WA X ACCOUNTING DEPARTMENT 5095758070 2811 TIETON DRIVE Yakima WA 989023799 DUANE ROSSMAN 2.00 X 0 0 0 Royal Keith 6.00 X 0 0 0 PAUL SCHAAKE 4.00 X 0 0 0 Bill Dolsen 4.00 X 0 0 0 James Berg 2.00 X 0 0 0 Connie Farina 2.00 X 0 0 0 Lisa Shields Long 2.00 X 0 0 0 StAN MARTINKUS 2.00 X 0 0 0 Brian Padilla 2.00 X 0 0 0 Keith Riffe 2.00 X 0 0 0 Scott Wagner 2.00 X 0 0 0 Roger Veilbig 2.00 X 0 0 0 Ben Soria 2.00 X 0 0 0 Darci Swanson 2.00 X 0 0 0 THOMAS STOKES 2.00 X 0 0 0 RICHARD SPIEGEL 2.00 X 0 0 0 Ross Katz 2.00 X 0 0 0 Craig Mendenhall 2.00 X 0 0 0 Richard W Linneweh Jr 40.00 X 550928 0 35818 JOHN G VORNBROCK 40.00 X 350575 0 265616 Brett Quave 40.00 X 1266288 0 34065 Gary D Bos 40.00 X 442586 0 30726 Roy S Pierson 40.00 X 457338 0 28726 Tony Ha 40.00 X 420008 0 33046 Daniel M Kwon 40.00 X 610846 0 32004 4098569 0 460001 110 0 1 1 Emergency Associates of Yakima 2811 Tieton Drive Yakima WA 98902 Physician Services 7219953 Physician Anesthesia Association 3003 Tieton Drive Yakima WA 98902 Physician Services 2419167 Yakima Valley Prof Svs on 12th PO Box 2947 Yakima WA 98907 Physician Services 2040632 Yakima Heart Center 406 South 30th Avenue Yakima WA 98902 Physician Services 1077342 Community Health of Central Washington 521 East Mountain View Avenue Ellensburg WA 98926 Physician Services 1058706 34 3111381 2183862 617882 117050 5913125 Net PATIENT REVENUES 900099 282622627 282622627 Educ Classes and Conv 900099 417968 417968 283040595 1064504 1064504 93996 93996 1811982 1862722 -50740 -50740 -50740 37988 121738 -83750 -83750 -83750 Memorial Physicians 541200 31596554 31596554 Cafe 722210 1574116 1574116 Laboratory Services 621500 649426 649426 933004 72204 860800 34753100 324730830 283040595 32318184 3458926 1473471 1473471 124868620 85524652 39343968 4223312 2892619 1330693 20370377 13952019 6418358 11375040 7790959 3584081 1076078 9305 1066773 250055 250055 48001928 36424319 11577609 64944691 56035698 8908993 5072378 5072378 5373943 1020769 4353174 730456 385287 345169 3477403 3477403 14307970 14307970 979634 561868 417766 LICENSES AND TAXES 6202374 6202374 Malpractice Out of Pock 1097197 1097197 UBIT 269 269 313825196 220002662 93822534 0 10669469 715345 2444194 1780599 39927065 59344686 637893 691147 5016755 5436438 2433225 2818335 260668482 147873661 105924459 112794821 40950690 44612873 178915 200022 27111485 28053929 235294150 256448195 74492750 80497307 54772 904339 59089039 54281370 5725832 5358695 822542 1123077 140184935 142164788 X 89744711 108918903 5051819 5051819 312685 312685 95109215 114283407 235294150 256448195 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 0 1 88265 88265 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: Part II-B Line 1i: The hospital paid lobbying expenses as a portion of various organization memberships in a total of $44,265. We also paid two companies for legislative consulting and lobbying a total amount of $44,000. 12706237 12706237 76508192 41140122 35368070 5822632 2808219 3014413 151890539 100415521 51475018 13740882 3509799 10231083 112794821 457b Plan Investments 811813 Other Receivables 1072640 Unamortized Bond Issue Costs 1369251 Investment In Subsidiaries 24800225 28053929 457b Plan Liability 811813 Liberty Building Annuity 187994 Long Term Lease Payable 123270 1123077 Part X: Description of Uncertain Tax Positions Under FIN 48: Effective November 1, 2009, the Hospital has adopted accounting for uncertain tax positiions. The accounting standard prescribes a recognition threshold and measurement process for uncertain tax positions. The Hospital had no uncertain tax positions as of October 31, 2010 and 2009 requiring accrual. 1 1 1 X 1 X 1 1 1 0 1 1 7058398 0 7058398 0.02250 55758164 39332373 16425791 0.05230 62816562 39332373 23484189 0.07480 4259627 1082221 3177406 0.01010 1347687 75 1347612 0.00430 2102785 2102785 0.00670 886167 382354 503813 0.00160 798393 166150 632243 0.00200 9394659 1630800 7763859 0.02470 72211221 40963173 31248048 0.09950 10783 10783 0.00000 37599 37599 0.00010 373 373 0.00000 45433 45433 0.00010 20917 20917 0.00010 1191078 648627 542451 0.00170 1306183 648627 657556 0.00200 1 2452639 0 88380831 107008379 -18627548 X 1 0 Yakima Valley Memorial Hospital Assoc

2811 Tieton Drive Yakima WA 98902

X X X X Garden Village

206 S 10th Ave Yakima WA 98902

Skilled nursing facility Yakima Valley Professional Services PC

PO Box 2947 yakima WA 98907

outpatient physician clinics Yakima Valley Prof Srvs on Tieton PC

PO Box 2947 Yakima WA 98907

outpatient physician clinics Yakima Gastroenterology Associates PC

3209 Creekside Loop Yakima WA 98902

Outpatient physician clinics Valley Imaging

314 S 11th Ave Yakima WA 98902

Diagnostic Imaging Yakima Internal Medicine Associates

3003 Tieton Drive Ste 320 Yakima WA 98902

Outpatient physician clinics Apple Valley Family Medicine

1008 S 38th Ave Yakima WA 98902

Outpatient physician clinics Selah Family Medicine

202 W Naches Ave Selah WA 98942

outpatient physician clinics Part I, Line 7: The hospital used ratio of patient care cost to charges methodology to calculate the amount reported in the table derived from worksheets 1 and 2. Part I, Line 7g: The amounts listed on this line are for operating losses of various physician clinics that operate at a loss. Part III, Line 4: The hospital used ratio of patient care cost to charges methodology to calculate the amount on line 2. Our financial statements do not include a footnote regarding bad debt and report bad debt as an expense. Part III, Line 8: To the extent that costs (using the medicare cost report) exceed charges, this shortfall should be regarded as community benefit because we treat and maintain the health of our large local medicare population despite the necessary subsidization of these health benefits. Part III, Line 9b: The hospital's collection policy doesn't address collection practices to be followed for patients who are known to qualify for charity or financial assistance. Line 1, Part V: Number of each type of healthcare facility other than those required to be licensed: Outpatient Physician Clinics: 7Line 6A, Part I: The annual community benefit report is available to the public upon request. Part VI, Line 2: Utilized data from county public health assessment. Part VI, Line 3: We have a charity care policy which has received state approval. There are numerous mechanisms documented under the policy for informing and educating patients and guarantors. Part VI, Line 4: The community served is primarily residents of Yakima County, Washington (population 240,000), with a small percentage (less than 15%) from outlying areas. Part VI, Line 5: #3 Community Support - Staff members attend meetings and participate on the committee for the community/region/county to plan and practice regional emergency response for disasters.#5 Leadership developement/training of community members - Organizational Health & Wellness department shares their training and expertise with the community through workshops and trainings. Temperament, Interaction Styles, into the Blue, and Leadership tools are used.#6 Coalition Building - Programs are developed and provided to the community. Rev It UP! is a coalition that coordinates the county-wide efforts toward Childhood Obesity prevention. The Youth Suicide Prevention Coalition provides training and education to the community to reduce suicide ideation, attempts, and completes within Yakima County.#7 Community Health Improvement Advocacy - YouthWorks is a youth improvement and community service initiative engaging youth directly through mentoring, volunteering & philanthropy.#8 Workforce Development - Departments and staff provide career development for students with disabilities. X X X 0 1 0 0 0 0 0 0 0 Richard W Linneweh Jr 550928 0 0 0 0 0 19750 0 16068 0 586746 0 0 0 JOHN G VORNBROCK 350575 0 0 0 0 0 247475 0 18141 0 616191 0 0 0 Brett Quave 1266288 0 0 0 0 0 12250 0 21815 0 1300353 0 0 0 Gary D Bos 442586 0 0 0 0 0 14830 0 15896 0 473312 0 0 0 Roy S Pierson 457338 0 0 0 0 0 10548 0 18178 0 486064 0 0 0 Tony Ha 420008 0 0 0 0 0 13578 0 19468 0 453054 0 0 0 Daniel M Kwon 610846 0 0 0 0 0 12250 0 19754 0 642850 0 0 0 Part I, Line 4b: In July 2002, the Hospital's Board of Trustees adopted a Salary Continuation Plan (the "Plan"), in the form of a non-qualified retirement benefit for senior executives (currently eight persons). The retirement benefit provided by the Plan is supplementary to the Hospital's employee Pension Plan, Tax-Deferred Annuity Retirement Plan, 401(k) Plan and Social security retirement earnings. Benefits are calculated as the difference between the projected age-65 value of the aforementioned benefits and 75% of the lump sum at age 65. No benefits under the Plan are generally available for a senior executive who retires prior to his/her 65th birthday. Funding for the Plan began in 2002, and the Hospital first began accruing a liability for the Plan during the fiscal year ending October 31, 2005. The Hospital's liability accrual is based on the assumption that all eight executives will be working until age 65. Given the short number of years between when the Hospital began accruing the benefits and when the first persons turn age 65, the accrual is disproportionate for the older senior executives. Mr. John G. Vornbrock is the Senior Vice President/CFO of Yakima Valley Memorial Hospital. As of 10/31/10, Mr. Vornbrock is 63 years old and has been in his current other senior administrative capacities at the Hospital since 1978. Mr Vornbrock accrued benefits under the plan in the amount of $229,608 during the 2009 calendar year. Washington Health Care Facilities Authority 911108929 NoneAvail 2007-05-21 6000000 Capital equipment lease 0 0 Washington Health Care Facilities Authority 911108929 NoneAvail 2009-08-20 4977500 Capital equipment lease 0 0 6055252 40000 6015252 2008 0 0 1 1 4977729 20500 4957229 2010 0 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 0 0 0 0 0 1 Diane Patterson Daughter of trustee 92127 Employed as Manager of Childrens Village 0 Jan Lange Former Trustee 139394 Medical Director Compensation 0 Emergency Associates of Yakima PLLC A Trustee is a phys. shareholder in the entity. 6659907 Emergency room physician compensation 0 Kate Rossman Daughter is trustee 62022 Employed in a Nursing Position 0 Roger Rowles Former Trustee 79201 Perinatal Medical Director and Ultrasound services compensation 0 Yakima Heart Center Inc PS Two trustees are phys. shareholders in the entity. 1329805 Eight service contracts related to cardiology 0 Ann Spiegel Wife of trustee 32780 Part-time laboratory employee 0 Michael Linneweh Son of Key Employee 28401 Employed in plant operations department. 0 X 2 117050 Appraisal 0 0 0 Method for Determining Number of Contributors: Part I, Column (b): Yakima Valley Memorial Hospital is reporting the number of contributors in column b. There were multiple works of art in one contribution and only one work of art in the other. Form 990, Part VI, Section A, line 2 Richard Spiegel and Roger Veilbig have a business relationship. Form 990, Part VI, Section B, line 11 Review is conducted by the Chief Accountant, CFO, CEO and board of Trustees. Form 990, Part VI, Section B, line 12c Conflicts are disclosed. Persons having a conflict may not be decision-makers in areas where conflicts exist. Form 990, Part VI, Section B, line 15 Compensation is set by a compensation committee of the Board of Trustees following review of comparability and performance data. Form 990, Part VI, Section C, line 19 Governing documents are filed with the Washington Secretary of State. Conflict of interest policy is contained in a business ethics brochure. Financial statements are filed with the Washington State Department of Health. Form 990, Part XI, Line 2c: No change from prior year. Yakima Valley Memorial Physicians PO Box 9787 Yakima WA 98909 753186720 Medical Services WA 31422571 0 Yakima Valley Memorial Hospital Memorial Physicians PO Box 2947 Yakima WA 98907 911615998 Practice Management and Billing WA 1818380 1079010 Yakima Valley Memorial Hospital Yakima Valley Memorial Hospital Charitable Fdn 2811 Tieton Drive Yakima WA 98902 911022358 Fundraising/Grants WA 501(c)(3) 11a N/A Garden Village 206 S 10th Ave Yakima WA 98902 912090034 Nursing Home WA 501(c)(3) 9 N/A Valley Imaging 314 S 11th Ave Suite B Yakima WA 98902 911926010 Imaging Services WA 501(c)(3) 11a N/A Heritage Grove 115 N 10th St Yakima WA 98901 911997947 Nursing Home WA 501(c)(3) 9 N/A Yakima Valley Professional Services on 12th PC PO Box 2947 Yakima WA 98907 020626810 Medical Services WA N/A C -2019881 1.00000 Yakima Neurosurgical Associates PC PO Box 2947 Yakima WA 98907 205646448 Medical Services WA N/A C -2003533 1.00000 Yakima Valley Professional Services PC PO Box 2947 yakima WA 98907 911878239 Medical Services WA N/A C -551954 1.00000 Yakima Plastic Surgery Associates PC 3003 Tieton Drive yakima WA 98902 205723270 Medical Services WA N/A C -410208 1.00000 Yakima Vascular Associates PC PO Box 2947 yakima WA 98902 264223730 Medical Services WA N/A C -374020 1.00000 General Surgeons on Tieton PC PO Box 2947 yakima WA 98902 261580261 Medical Services WA N/A C -716108 1.00000 Yakima Gastroenterology Associates PC PO Box 2947 yakima WA 98902 912107549 Medical Services WA N/A C -770087 1.00000 Memorial Hospital Physicians PO Box 2947 yakima WA 98907 264204767 Medical Services WA N/A C -347105 1.00000 Yakima Valley Prof Services on Tieton pO Box 2947 Yakima WA 98907 911913298 Medical Services WA N/A C -591810 1.00000 Yakima Internal Medicine 3003 Tieton Drive yakima WA 98902 911973070 medical Services WA N/A C 1.00000 Selah Family Medicine 620 N Park Drive Selah WA 98942 medical Services WA N/A C 1.00000 Memorial Sleep Specialists 406 S 30th Ave Ste 206 yakima WA 98902 medical Services WA N/A C 1.00000 Yakima ENT PO Box 2947 yakima WA 98902 medical Services WA N/A C 1.00000 Apple Valley Family Medicine 1008 S 38th Ave 110 yakima WA 98902 912029979 medical Services WA N/A C 1.00000 1 1 1 0 0 0 1 0 0 0 1 1 1 1 1 1 0 1 Apple Valley Family Medicine B 72395 Yakima Gastroenterology Associates PC B 369938 Yakima Valley Professional Services on Tieton PC B 104672 Yakima Valley Professional Services on Tieton PC L 340346 Yakima Plastic Surgery Associates PC A 56607 Yakima Plastic Surgery Associates PC B 94912 General Surgeons on Tieton PC A 75960 General Surgeons on Tieton PC B 405166 General Surgeons on Tieton PC L 338723 Heritage Grove P 56218 Valley Imaging B 278304 Valley Imaging L 408819 Valley Imaging P 236834 Valley Imaging R 2500000 Yakima Valley Professional Services on 12th PC B 200000 Yakima Valley Professional Services on 12th PC L 1499084 Yakima Valley Professional Services on 12th PC P 416227 Yakima Valley Professional Services PC B 229224 Yakima Neurosurgical Associates PC A 66560 Yakima Neurosurgical Associates PC B 886156 Memorial Hospital Physicians B 60000 Yakima Vascular Associates PC B 316253 Yakima Valley Memorial Hospital Charitable Foundation C 2119321 garden Village B 649708 garden Village K 666836 Garden Village P 194251 Selah Family Medicine B 69327