2023-11-13T16:20:57-06:00 2021-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2021-01-01 814670687 SHC MEDICAL CENTER - TOPPENISH SHCM 5098653105 1016 TACOMA AVE SUNNYSIDE WA 98944 MAXWELL OWENS CFO 5098653105 2023-11-13 1 MAXWELL OWENS 999009999 COLLEEN RAMIRES P01251320 4252597227 2023-11-13 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ASTRIA TOPPENISH HOSPITAL BRIAN GIBBONS 1016 TACOMA AVE SUNNYSIDE WA 98944 52228854 0 X WWW.ASTRIA.HEALTH X 2016 WA PROVIDE HEALTHCARE SERVICES TO THE COMMUNITIES SERVED. 6 4 447 4 0 0 9757513 2459530 37119586 49343956 0 1 196653 425367 47073752 52228854 0 0 0 0 20336575 22894994 0 0 0 16446158 31094612 36782733 53989606 10291019 -1760752 18570913 20059733 21227908 22228877 -2656995 -2169144 PROVIDE HEALTHCARE SERVICES TO THE COMMUNITIES SERVED. 0 0 35158138 49343956 SHC MEDICAL CENTER - TOPPENISH DBA ASTRIA TOPPENISH HOSPITAL (THE HOSPITAL) IS A 78-BED FACILITY PROVIDING MEDICAL SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. THE HOSPITAL HAS AN EXPANDED SURGERY CAPABILITY, A PEDIATRICS AREA AND A FAMILY MATERNITY CENTER. THE HOSPITAL PROVIDED 8,012 PATIENT DAYS, 83,375 OUTPATIENT VISITS, 14,633 EMERGENCY ROOM VISITS, AND 266 BIRTHS DURING THE REPORTING PERIOD. SHC TOPPENISH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $136,647,952 FOR CHARITY CARE, MEDICARE, MEDICAID AND OTHER THIRD PARTY PAYORS FOR THE YEAR. 35158138 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 56 0 1 447 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MAXWELL OWENS 5098653105 1016 TACOMA AVE SUNNYSIDE WA 98944 BERTHA ORTEGA BOARD CHAIR 1.00 X X 0 0 0 CARRIE STORY BOARD VICE CHAIR 1.00 X X 0 0 0 STEVE YOUNG TRUSTEE 1.00 X 0 0 0 LORI ALVORD MD TRUSTEE 1.00 39.00 X 0 475500 45622 MAXINE JANIS TRUSTEE (THRU 12/21) 1.00 X 0 0 0 BRIAN GIBBONS CEO 5.00 35.00 X X 0 640565 46782 BRYAN HARGIS CEO (THRU 09/21) 39.00 1.00 X 0 201669 18841 MAXWELL OWENS CFO 5.00 35.00 X 0 379622 24604 TERRA PALOMAREZ CNO (THRU 11/21) 40.00 X 0 222394 26699 SCOTT HEFLICK PHYSICIAN 40.00 X 310267 0 34281 CRAIG WHITTLESEY PHYSICIAN 40.00 X 328063 0 38093 ANTONY KIM PHYSICIAN 40.00 X 514380 0 45622 CHARLES BULFINCH PHYSICIAN 40.00 X 532428 0 50313 ADRIAN OBUCH PHYSICIAN 40.00 X 572176 0 30195 2257314 1919750 361052 34 0 1 0 AYA HEALTHCARE INC DEPARTMENT 3519 DALLAS TX 75312 CONTRACT NURSING 3929569 LOCUM TENENS PO BOX 405547 ATLANTA GA 30384 CONTRACT PHYSICIANS 1253843 RURAL PHYSICIANS GROUP 10624 S EASTERN AVE SUITE A263 HENDERSON NV 89052 CONTRACT PHYSICIANS 1047006 SUNNYSIDE EMERGENCY GROUP A PROF LLC PO BOX 677979 DALLAS TX 75267 CONTRACT PHYSICIANS 667978 EVERGREEN ANESTHESIA ASSOCIATES PO BOX 3442 IDAHO FALLS ID 83403 ANESTHESIA SERVICES 276857 14 2205589 253941 2459530 NET PATIENT SERVICE REVENUE 624100 49343956 49343956 49343956 1 1 OTHER REVENUE 900099 327048 327048 DIETARY REVENUE 722514 98319 98319 425367 52228854 49343956 0 425368 X 19210314 16905076 2305238 521861 459238 62623 1842933 1621781 221152 1319886 1161500 158386 509456 509456 13861 13861 17450 17450 7899234 7662257 236977 779598 678250 101348 1717 1494 223 1449609 985734 463875 144579 30362 114217 71575 15031 56544 2566238 2566238 656912 656912 419970 33598 386372 PURCHASED SERVICES 10576280 1586442 8989838 MEDICAL SUPPLIES 4021552 3498750 522802 TAXES, DUES, & LICENSES 1378731 289534 1089197 MAINTENANCE & REPAIRS 377789 79336 298453 210061 149755 60306 53989606 35158138 18831468 0 1635665 114438 5729285 8865278 476012 0 1111635 2450432 556611 305615 11237181 3480172 8098274 7757009 963431 566961 18570913 20059733 7381898 5293881 11487110 0 2358900 2358900 0 14576096 21227908 22228877 X -2656995 -2169144 -2656995 -2169144 18570913 20059733 -1760752 2248603 0 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 550000 550000 8034842 2014147 6020695 2370013 1461568 908445 282326 4457 277869 7757009 RELATED PARTY PAYABLES 14576096 14576096 X PART X, LINE 2: THE ORGANIZATION COMPRISES SEVERAL CORPORATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515, AND SEVERAL LIMITED LIABILITY COMPANIES. THE ORGANIZATION HAS ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS, WHICH IS AN ACCOUNTING STANDARD THAT PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021. 1 1 1 X 1 X 1 1 0 0 292975 292975 0.00540 23093447 18298300 4795147 0.08900 23386422 18298300 5088122 0.09440 23386422 18298300 5088122 0.09440 1 133725 4825272 7056944 -2231672 X 1 1 1 1 ASTRIA TOPPENISH HOSPITAL 502 W 4TH TOPPENISH WA 98948 WWW.ASTRIA.HEALTH X X X ASTRIA TOPPENISH HOSPITAL 1 0 0 1 X X X X X X X X 21 1 1 0 1 X SEE PART V X 1 21 1 SEE PART V 0 1 X 150.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X 1 X 0 0 ASTRIA TOPPENISH HOSPITAL PART V, SECTION B, LINE 5: TO ASSURE COMMUNITY ENGAGEMENT AND VOICE IN THE CHNA PROCESS, ASTRIA HAD PLANNED A ROBUST IN-PERSON COMMUNITY CONVENING PROCESS TO ASSESS, IDENTIFY, AND PRIORITIZE COMMUNITY NEEDS. AFTER MUCH DISCUSSION, DUE TO THE UNRELENTING NATURE OF COVID IN THE COMMUNITY, ASTRIA CHOSE TO USE A COMBINATION OF ONLINE SURVEYS, FOCUS GROUPS AND ONE-ON-ONE PHONE INTERVIEWS WITH SERVICE AREA AND COUNTY COMMUNITY MEMBERS AND ORGANIZATIONS SERVING THE VULNERABLE. A SIMILAR PROCESS WAS USED WITH ASTRIA LEADERSHIP AND MANAGEMENT. KEY STAKEHOLDER INTERVIEWS: STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY INCLUDING PUBLIC HEALTH, TRIBAL HEALTH, AND INDIVIDUALS WITH KNOWLEDGE OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE. INDIVIDUALS TO BE INTERVIEWED WERE RECOMMENDED BY ASTRIA HEALTH SENIOR LEADERSHIP.KEY STAKEHOLDER SURVEY: A KEY STAKEHOLDER SURVEY WAS DISTRIBUTED TO PROVIDERS (PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS), THE CLINICAL MANAGEMENT STAFF OF ASTRIA HEALTH, AND COMMUNITY ORGANIZATIONS WITH KNOWLEDGE AND EXPERTISE REGARDING THE NEEDS OF UNDERSERVED, AT-RISK AND VULNERABLE POPULATIONS, AND THOSE WITH CHRONIC DISEASE. SURVEYS WERE RECEIVED FROM THE FOLLOWING ORGANIZATION TYPES:- CITY GOVERNMENT- SCHOOLS- HIGHER EDUCATION AND WORK FORCE DEVELOPMENT- COMMUNITY SERVICE ORGANIZATIONS- SOCIAL SERVICES AGENCIES- COMMUNITY HEALTH CENTERS- HOSPITAL PROVIDERS- LOCAL BUSINESSES- LOCAL UTILITY ORGANIZATIONS- EMERGENCY RESPONDERSTHE FOLLOWING NUMBER OF RESPONSES WERE RECEIVED FROM SURVEYS AND FOCUS GROUPS: - INTERVIEW WITH YAKIMA HEALTH DISTRICT - 15 COMMUNITY SURVEYS - 29 ASTRIA HEALTH MANAGERS AND LEADERSHIP SURVEYS - 8 FOCUS GROUP PARTICIPANTS - 3 INDIVIDUAL MEETINGS ASTRIA HEALTH CONTRACTED WITH HEALTH FACILITIES PLANNING & DEVELOPMENT (HFPD) TO ASSIST IN CONDUCTING THE CHNA. HFPD IS A HEALTH CARE CONSULTING COMPANY BASED IN SEATTLE, WASHINGTON. ASTRIA TOPPENISH HOSPITAL PART V, SECTION B, LINE 6A: SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION (DBA ASTRIA SUNNYSIDE HOSPITAL) ASTRIA TOPPENISH HOSPITAL PART V, SECTION B, LINE 11: UTILIZING THE PRIORITIZATION CRITERIA AND GROUP DISCUSSION, THE SENIOR LEADERSHIP TEAM CHOSE THREE PRIORITY COMMUNITY HEALTH NEEDS AS FOCUS AREAS FOR ASTRIA HEALTH OVER THE NEXT THREE YEARS. THESE COMMUNITY HEALTH NEEDS ARE IDENTIFIED AND ADDRESSED IN THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE IN ALIGNMENT WITH THE COMMUNITY HEALTH NEEDS IDENTIFIED BY KEY STAKEHOLDERS. LISTED BELOW ARE THE THREE SIGNIFICANT NEEDS AND HOW THE HOSPITAL IS ADDRESSING THESE NEEDS.(1) INCREASE ACCESS TO BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES.- CONTINUE EFFORTS TO INTEGRATE AND CO-LOCATE PRIMARY CARE AND BEHAVIORAL HEALTH (INCLUDING MEDICATION MANAGEMENT, MENTAL HEALTH THERAPY, AND SUBSTANCE USE DISORDER SCREENING).- INCREASE COMPLIANCE WITH ANNUAL WELLNESS VISITS FOR CURRENT PATIENT PANEL TO ENSURE STANDARDIZED BEHAVIORAL HEALTH SCREENINGS ARE COMPLETED.- INCREASE COMPLIANCE WITH STANDARDIZED BEHAVIORAL HEALTH SCREENINGS (AT WELLNESS VISITS FOR CURRENT CLINIC PATIENT PANELS AND FOR ACUTE CARE AND EMERGENCY VISITS) AND ENSURE PATIENTS ARE REFERRED TO NEEDED SERVICES.- INCREASE THE NUMBER OF ASTRIA EMPLOYED MEDICATION ASSISTED THERAPY (MAT) PROVIDERS.- COORDINATE WITH YAKAMA NATION PRIMARY CARE AND BEHAVIORAL HEALTH/SUBSTANCE ABUSE DISORDER PROVIDERS.- EXPAND THE INPATIENT BEHAVIORAL HEALTH PROGRAM AT ASTRIA TOPPENISH HOSPITAL.(2) IMPROVE ACCESS TO CARE (PRIMARY AND SPECIALTY) FOR PREVENTION, SCREENING, AND TREATMENT OF CHRONIC DISEASES, DENTAL CARE, AND CARE TRANSITIONS AND CARE COORDINATION.- DEVELOP A COMPREHENSIVE PROGRAM FOR DISCHARGE PLANNING FOCUSED ON CONNECTING HIGH-RISK PATIENTS TO PRIMARY CARE PROVIDERS AND COMMUNITY RESOURCES.- IMPROVE SYSTEM FOR IDENTIFICATION AND TREATMENT OF CHRONIC DISEASES BY CONTINUING/EXPANDING STRATEGIES DEVELOPED THROUGH GREATER COLUMBIA ACH.- EXPAND HOME MONITORING PROGRAM FOR PATIENTS WITH HIGH BLOOD PRESSURE.- PILOT EMBEDDING COMMUNITY HEALTH WORKERS WITHIN PRIMARY CARE TO SUPPORT CARE TRANSITIONS AND CARE COORDINATION.- PARTICIPATE IN COMMUNITY OUTREACH EVENTS TO IDENTIFY COMMUNITY MEMBERS AT RISK OF CHRONIC DISEASES AND CONNECT THEM TO PRIMARY CARE PROVIDERS.- IMPLEMENT INTEGRATED DENTAL SERVICES IN RURAL HEALTH CLINICS.- DEVELOP RELATIONSHIPS WITH LARGE AGRICULTURAL EMPLOYERS TO PROVIDE PREVENTATIVE HEALTH SERVICES TO EMPLOYEES WHO MAY NOT BE ABLE TO ACCESS CARE DURING TRADITIONAL HOURS.- ESTABLISH A 27-STATION OUTPATIENT DIALYSIS FACILITY FOR END-STAGE RENAL DISEASE.- RECRUIT ADDITIONAL PRIMARY CARE AND SPECIALTY PROVIDERS TO THE COMMUNITY.- EXPAND ENDOSCOPY AND SURGICAL SERVICES THROUGH ASTRIA TOPPENISH HOSPITAL.(3) ADDRESSING SOCIAL DETERMINANTS OF HEALTH INCLUDING HOUSING AFFORDABILITY, ACCESS, AND QUALITY; FOOD INSECURITY; PROVIDE TRAINING AND INCREASE EFFORTS TO IMPROVE HEALTH EQUITY; CARE TRANSITIONS AND CARE COORDINATION.- DEVELOP A LIST OF COMMUNITY RESOURCES ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND ESTABLISH FORMAL SYSTEM FOR COLLABORATION- ESTABLISH A SYSTEM FOR SCREENING PATIENTS FOR ASSISTANCE WITH SOCIAL DETERMINANTS OF HEALTH (SDOH) AND ESTABLISH A COMMUNITY REFERRAL SYSTEM.- PARTNER WITH THE COMMUNITY TO INCREASE AFFORDABLE HOUSING OPTIONS- CONDUCT A HEALTH EQUITY ASSESSMENT, IDENTIFY SPECIFIC HEALTH EQUITY ISSUES WITHIN THE ASTRIA HEALTH SYSTEM, IDENTIFY TRAINING NEEDS AND IMPLEMENT HEALTH EQUITY TRAINING ACROSS THE SYSTEM. ASTRIA TOPPENISH HOSPITAL PART V, SECTION B, LINE 13H: HARDSHIP AND DEBT RATIO ASTRIA TOPPENISH HOSPITAL PART V, SECTION B, LINE 15E: DESCRIBED THE APPEALS PROCESS SHOULD IT BE DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. ASTRIA TOPPENISH HOSPITAL PART V, SECTION B, LINE 16J: AS PART OF THE INTAKE OR DISCHARGE PROCESS, PATIENTS ARE OFFERED A PATIENT INFORMATION PACKET THAT OUTLINES PAYMENT PLAN OPTIONS AND FINANCIAL ASSISTANCE POLICY INFORMATION INCLUDING THE PLAIN LANGUAGE SUMMARY. THE POLICY WILL BE INTERPRETED FOR OTHER NON-ENGLISH SPEAKING OR LIMITED ENGLISH SPEAKING OR OTHER PATIENTS WHO ARE UNABLE TO READ OR UNDERSTAND THE WRITTEN POLICY OR ORAL EXPLANATION.PART V, SECTION B, LINES 16A - 16C: THE CHARITY CARE POLICY, APPLICATION, AND PLAIN LANGUAGE OF APPLICATION CAN BE FOUND AT THE FOLLOWING URL: ASTRIA.HEALTH/CHARITY-CARE/ PART V, SECTION B, LINE 7A: ASTRIA.HEALTH/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, SECTION B, LINE 10A: ASTRIA.HEALTH/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 3 1 - ASTRIA HEALTH CENTER 1420 AHTANUM RIDGE DRIVE UNION GAP WA 98903 RURAL HEALTH CLINIC 2 - ASTRIA HEALTH CENTER 516 W 4TH AVENUE TOPPENISH WA 98948 RURAL HEALTH CLINIC 3 - ASTRIA HEALTH CENTER 915 VINTAGE VALLEY PKWY STE 200 ZILLAH WA 98983 RURAL HEALTH CLINIC 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 FROM THE IRS INSTRUCTIONS FOR SCHEDULE H.BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN: $133,725.DUE TO BANKRUPTCY AND TURN OVER, THE HOSPITAL WAS NOT ABLE TO CAPTURE DOLLAR AMOUNTS ASSOCIATED WITH ITS COMMUNITY BENEFIT ACTIVITIES CONDUCTED IN 2021. LINE 7E - THE HOSPITAL PROVIDED COMMUNITY HEALTH OUTREACH AND SUPPORT WITH VACCINATION RESPONSE DURING THE COVID-19 PANDEMIC. THE HOSPITAL NURSING AND LEADERSHIP TEAMS WERE INSTRUMENTAL IN VACCINATING ASTRIA HEALTH EMPLOYEES, COMMUNITY FIRST RESPONDERS AND ELIGIBLE COMMUNITY VACCINE RECIPIENTS. MULTIPLE VACCINE CLINICS WERE FACILITATED WITHIN THE HOSPITAL AND EXPANDED OUT INTO LARGER LOCATIONS WITH THE COMMUNITY TO REACH MORE PEOPLE. MORE THAN 7,300 DOSES OF THE VACCINE WERE ADMINISTERED TO PROTECT OUR COMMUNITY AND HEALTHCARE WORKERS. PART III, LINE 2: THE HOSPITAL USED THE COST TO CHARGE RATIO OF PATIENT CARE TO DETERMINE THE COST OF BAD DEBT EXPENSE. PART III, LINE 3: THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. PART III, LINE 4: SEE PAGE 7 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. PART III, LINE 9B: OUR PATIENT NAVIGATOR WILL VISIT WITH ANY PATIENT THAT DISCLOSES THEY HAVE FINANCIAL DIFFICULTY TO DETERMINE IF THE PATIENT QUALIFIES FOR CHARITY CARE BASED ON THEIR FINANCIAL POSITION AND THE FEDERAL POVERTY GUIDELINES. THE APPLICATIONS ARE REVIEWED AND EVALUATED FOR CHARITY CARE STATUS AND WRITTEN OFF WHEN APPROPRIATE. PART VI, LINE 2: THE HOSPITAL BOARD, THROUGH ASSOCIATION WITH HEALTHTECHS3, ANNUALLY REVIEWS COMMUNITY DEMOGRAPHICS, PATIENT ORIGINS, CURRENT SERVICES AND FUTURE NEEDS. FROM THIS REVIEW, THE BOARD CONTINUALLY ASSESSES THE COMMUNITY NEEDS. MANAGEMENT, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. PART VI, LINE 3: THE INFORMATION IS DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. A BROCHURE IS PLACED IN PUBLIC AREAS OF THE HOSPITAL, AS WELL AS INCLUDED IN ALL FORMAL ADMISSION PACKETS TO PATIENTS. PATIENT ACCOUNT REPRESENTATIVES HAND OUT THE INFORMATION DURING PATIENT CONSULTS AS WELL. SIGNS ARE POSTED, IN ENGLISH AND IN SPANISH, IN ALL REGISTRATION AND WAITING AREAS, AND THE BUSINESS OFFICE. THE SIGN STATES: "ASTRIA SUNNYSIDE HOSPITAL PROVIDES CHARITY CARE TO PERSONS MEETING MEDICAL INDIGENT CRITERIA. CHARGES MAY BE WAIVED OR REDUCED IF ELIGIBILITY FOR CHARITY CARE IS DETERMINED." THE INFORMATION IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE AND INCLUDED WITH EVERY PATIENT ACCOUNT STATEMENT. PART V, SECTION B, LINE 16 OUTLINES ADDITIONAL WAYS THE ORGANIZATION PUBLICIZES ITS FINANCIAL ASSISTANCE INFORMATION. THE LATEST CHARITY CARE POLICY IS AVAILABLE ON OUR WEBSITE. IT IS UPDATED ANNUALLY WITH NEW POVERTY GUIDELINES. PART VI, LINE 4: THE HOSPITAL IS LOCATED IN YAKIMA COUNTY WITHIN THE YAKIMA INDIAN RESERVATION IN TOPPENISH, WASHINGTON. THE HOSPITAL SERVICES A PRIMARY POPULATION OF APPROXIMATELY 46,200 WITH A MEDIAN HOUSEHOLD INCOME OF $51,415. APPROXIMATELY 21% OF RESIDENTS HAVE INCOMES BELOW FEDERAL POVERTY GUIDELINES. 66.0% OF RESIDENTS IDENTIFY AS HISPANIC ETHNICITY WITH A SIZABLE NUMBER OF SPANISH-PRIMARY SPEAKERS AND 15.3% AS NON-HISPANIC AMERICAN INDIANS. RESIDENTS OF THIS AREA ARE SIGNIFICANTLY YOUNGER THAN RESIDENTS OF YAKIMA COUNTY AND WASHINGTON STATE, WITH APPROXIMATELY 34% BEING UNDER THE AGE OF 18 COMPARED TO JUST OVER 22% STATEWIDE. APPROXIMATELY 10% OF RESIDENTS ARE 65 OR OLDER. PART VI, LINE 5: THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF THE COMMUNITY FROM THE MEDICAL SECTOR TO BUSINESS OWNERS TO UNIVERSITY STAFF. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS.MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED AND INTERESTED MEDICAL PROVIDERS WITH ACTIVE LICENSURE IN THE COMMUNITIES WE SERVE. THE HOSPITAL ENCOURAGES PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER-EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY.AS A NON-PROFIT CORPORATION, SURPLUS FUNDS ARE REINVESTED INTO BUILDING AND EQUIPMENT UPGRADES AND COMMUNITY HEALTH EDUCATION TO MAINTAIN THE HIGHEST QUALITY HEALTHCARE FOR OUR COMMUNITY. SURPLUS FUNDS ARE ALSO APPLIED TO ONGOING PROFESSIONAL EDUCATION AMONG OUR CLINICAL STAFF TO REMAIN CURRENT IN THE BEST PRACTICES OF HEALTHCARE. THIS ALLOWS THE HOSPITAL TO FOCUS ON WHAT IS IMPORTANT - MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITIES WE SERVE IN AN ECONOMICALLY VIABLE FASHION.THE HOSPITAL'S CHARITY CARE PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE FINANCIAL RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTHCARE THEY RECEIVE. THE CHARITY CARE PROGRAM IS DESIGNED TO ENSURE THAT THE YAKIMA VALLEY IN ITS ENTIRETY HAS ACCESS TO NECESSARY HEALTHCARE SERVICES. THE HOSPITAL ACCEPTS ALL PATIENTS IN NEED OF MEDICAL ASSISTANCE, REGARDLESS OF ABILITY TO PAY.THE HOSPITAL OPERATES A FULLY STAFFED 24-HOUR EMERGENCY ROOM, AVAILABLE TO THE PUBLIC REGARDLESS OF ABILITY TO PAY.IN ADDITION TO THE CHARITY CARE PROGRAM, THE HOSPITAL PROVIDES OR PARTICIPATES IN SEVERAL OTHER PROGRAMS WHICH CONTRIBUTE TO ITS CHARITABLE MISSION. THIS INCLUDES HOSTING AN ANNUAL HEALTH FAIR WITH FREE ACCESS TO HEALTHCARE PROFESSIONALS, FREE SCREENINGS AND A WEALTH OF HEALTH AND WELLNESS INFORMATION MADE AVAILABLE TO THE PUBLIC, AS WELL AS PUTTING ON A COMMUNITY BABY SHOWER FOR PREGNANT PATIENTS WITHIN THE COMMUNITY. PART VI, LINE 6: THE HOSPITAL, ALONG WITH ASTRIA SUNNYSIDE HOSPITAL, IS PART OF THE ASTRIA HEALTH SYSTEM, HEADQUARTERED IN THE HEART OF YAKIMA VALLEY IN THE STATE OF WASHINGTON. THIS NON-PROFIT HEALTHCARE SYSTEM IS COMMITTED TO INVESTING IN A CONTINUUM OF CARE FOR THE PEOPLE WHO LIVE AND WORK THROUGHOUT EASTERN WASHINGTON AND BUILD SUSTAINABLE HEALTHCARE ORGANIZATIONS THAT IMPROVE HEALTH IN THE COMMUNITIES WE SERVE.ASTRIA SUNNYSIDE HOSPITAL IS LOCATED IN SUNNYSIDE WASHINGTON AND ASTRIATOPPENISH HOSPITAL IS LOCATED IN TOPPENISH WASHINGTON. THE SERVICE AREA IS DEFINED AS YAKIMA COUNTY AND THE COMMUNITIES OF PROSSER WHICH IS IN BENTON COUNTY AND ELLENSBURG WHICH IS IN KITTITAS COUNTY.ASTRIA SUNNYSIDE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND ALSO OPERATES A NUMBER OF RURAL HEALTH CLINICS. ASTRIA TOPPENISH HOSPITAL IS A COMMUNITY HOSPITAL AND CARES FOR THE UNIQUE NEEDS OF THE TOPPENISH AREA, INCLUDING CARING FOR PEOPLE LIVING AND WORKING ON THE YAKAMA NATION. 0 0 0 0 0 0 0 0 0 BRIAN GIBBONS CEO 0 416483 0 218699 0 5383 0 11400 0 35382 0 687347 0 0 ADRIAN OBUCH PHYSICIAN 572124 0 0 0 52 0 11400 0 18795 0 602371 0 0 0 CHARLES BULFINCH PHYSICIAN 532428 0 0 0 0 0 11400 0 38913 0 582741 0 0 0 ANTONY KIM PHYSICIAN 514380 0 0 0 0 0 11400 0 34222 0 560002 0 0 0 LORI ALVORD MD TRUSTEE 0 475500 0 0 0 0 0 11400 0 34222 0 521122 0 0 MAXWELL OWENS CFO 0 308674 0 64365 0 6583 0 11400 0 13204 0 404226 0 0 CRAIG WHITTLESEY PHYSICIAN 228759 0 95978 0 3326 0 12081 0 26012 0 366156 0 0 0 SCOTT HEFLICK PHYSICIAN 226758 0 83509 0 0 0 9282 0 24999 0 344548 0 0 0 TERRA PALOMAREZ CNO (THRU 11/21) 0 197305 0 24300 0 789 0 8037 0 18662 0 249093 0 0 BRYAN HARGIS CEO (THRU 09/21) 0 197871 0 0 0 3798 0 7548 0 11293 0 220510 0 0 PART I LINE 3 THE ORGANIZATION CONTRACTS WITH REGIONAL HEALTH DBA ASTRIA HEALTH (ASTRIA HEALTH) FOR MANAGEMENT SERVICES. ASTRIA HEALTH DETERMINES THE CEO, CFO AND CNO SALARIES. ASTRIA HEALTH ESTABLISHES SALARIES AT THE TIME OF HIRE AND PERIODICALLY REVIEWS THEM THEREAFTER. TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY RELATED EXPERIENCE B) PREVAILING CEO AND CFO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR BUSINESSES OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA; AND C) ASTRIA HEALTH'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY ASTRIA HEALTH'S BOARD OR A SUBCOMMITTEE THEREOF. IN ADDITION TO BASE SALARY, THE CEO AND CFO MAY BE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON PERFORMANCE PARAMETERS ESTABLISHED BY ASTRIA HEALTH AND APPROVED BY THE ASTRIA HEALTH BOARD. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ASTRIA HEALTH (AH). AH, AS THE PARENT AND SYSTEM ENTITY, PROVIDES THE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT NON-PROFIT CORPORATE ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING MANAGEMENT OF: - EXECUTIVE ACTIVITIES - INFORMATION SYSTEMS - FINANCIAL OPERATIONS - HEALTH INFORMATION AND RECORDS - SCHEDULING AND REFERRALS - HUMAN RESOURCES - MATERIALS AND SUPPLIES - MEDICAL STAFF AND PHYSICIANS SERVICES - QUALITY RESOURCES - RISK MANAGEMENT - MARKETING AND COMMUNITY RELATIONS - SHARED SERVICES DIRECTORS FOR LABORATORY THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY AH: BRIAN GIBBONS $687,347 (COMPENSATION FOR SERVICES AS AN OFFICER OF AH AND RELATED TAX-EXEMPT ENTITIES) MAXWELL OWENS $404,226 (COMPENSATION FOR SERVICES AS AN OFFICER OF AH AND RELATED TAX-EXEMPT ENTITIES) BRYAN HARGIS $212,962 TERRA PALOMAREZ $249,094 FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN 2021 TO UPDATE THE PURPOSE TO CARRYING OUT THE CHARITABLE PURPOSE OF ASTRIA HEALTH AND THE SYSTEM OF CONTROLLED CHARITABLE CORPORATIONS WHICH ASTRIA HEATH HAS CREATED OR OTHERWISE AFFILIATED WITH. FORM 990, PART VI, SECTION A, LINE 6 SHC HOLDCO, LLC, A DISREGARDED ENTITY OF ASTRIA HEALTH, IS THE SOLE MEMBER OF SHC MEDICAL CENTER - TOPPENISH DBA ASTRIA TOPPENISH HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A SHC HOLDCO, LLC, A DISREGARDED ENTITY OF ASTRIA HEALTH, AS THE MEMBER OF THE ORGANIZATION HAS SOLE AUTHORITY TO APPOINT THE ORGANIZATION'S BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B SHC HOLDCO, LLC, A DISREGARDED ENTITY OF ASTRIA HEALTH, AS THE MEMBER OF THE ORGANIZATION HAS SOLE AUTHORITY TO: - APPOINT OR REMOVE OFFICERS - OVERSIGHT AND APPROVAL OF OFFICER AND PHYSICIAN COMPENSATION - CHANGE THE MISSION AND PHILOSOPHY - ADOPT, AMEND OR REPEAL GOVERNING DOCUMENTS - ESTABLISH PARAMETERS AROUND ACQUIRING OR DISPOSING OF ASSETS, INCURRING INDEBTEDNESS OR ENTERING LEASES - APPROVE ANY CORPORATE RESTRUCTURING INCLUDING MERGERS AND DISSOLUTIONS - APPROVE ANNUAL STRATEGIC PLANS AND CAPITAL BUDGETS - APPOINT AUDITORS - CAUSE THE ISSUANCE OR REDEMPTION OF A MEMBERSHIP TO OR FROM ANY PERSON OR ENTITY FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO ASTRIA HEALTH'S CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER PRIOR TO APPROVAL OF THE 990. A DRAFT IS ALSO DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO AUTHORIZES THE PREPARER TO FINALIZE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD FILLS OUT A CONFLICT OF INTEREST FORM DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR THROUGH SELF DISCLOSURE IN THE INTERIM. IF A POTENTIAL CONFLICT ARISES, THE AFFECTED PERSON SHALL FULLY DISCLOSE THE NATURE OF THE INTEREST AND WITHDRAW FROM DISCUSSION AND VOTING ON THE MATTER. ANY TRANSACTION OR VOTE INVOLVING A POTENTIAL CONFLICT OF INTEREST SHALL BE APPROVED ONLY WHEN A MAJORITY OF DISINTERESTED DIRECTORS DETERMINE THAT IT IS IN THE BEST INTEREST OF SHC TOPPENISH TO DO SO. SHC TOPPENISH HAS A COMPLIANCE AND MONITORING POLICY THAT IS ENFORCED BY THE CEO. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - THE CEO IS EMPLOYED AND COMPENSATED THROUGH ASTRIA HEALTH, A RELATED ORGANIZATION. THE SALARY IS ESTABLISHED AT THE TIME OF HIRE, AND PERIODICALLY THEREAFTER, TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY RELATED EXPERIENCE. B) PREVAILING CEO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR HOSPITALS OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA. C) ASTRIA HEALTH'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY THE HOSPITAL BOARD OR A SUBCOMMITTEE THEREOF. THE DEPARTING CEO'S COMPENSATION WAS REVIEWED IN 2021. THE NEW CEO'S COMPENSATION WAS LAST DETERMINED UPON HIRE IN 2020. LINE 15B - THE CFO AND CNO'S COMPENSATION IS DETERMINED IN THE SAME MANNER AS THE CEO'S. THE CFO'S COMPENSATION WAS LAST DETERMINED UPON HIRE IN 2020. THE CNO'S COMPENSATION WAS LAST REVIEWED IN 2021. FORM 990, PART VI, SECTION C, LINE 19 SHC TOPPENISH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 7,662,257. MANAGEMENT AND GENERAL EXPENSES 236,977. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,899,234. ASTRIA HEALTH 1016 TACOMA AVE SUNNYSIDE WA 98944 813973675 MANAGEMENT WA 501(C)(3) LINE 12C, III-FI N/A 0 ASTRIA SUNNYSIDE FOUNDATION DBA ASTRIA HEALTH FOUNDATION PO BOX 719 SUNNYSIDE WA 98944 912000867 FUNDRAISING WA 501(C)(3) LINE 12A, I SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION DBA ASTRIA SUNNYSIDE HOSPITAL 0 SHC MEDICAL CENTER - YAKIMA DBA ASTRIA REGIONAL MEDICAL CENTER 1016 TACOMA AVE SUNNYSIDE WA 98944 814653630 HEALTHCARE WA 501(C)(3) LINE 3 SHC HOLDCO LLC 0 SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION PO BOX 719 SUNNYSIDE WA 98944 911286274 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 SUNNYSIDE HOME HEALTH DBA ASTRIA HOME HEALTH 812 MILLER AVE SUITE A SUNNYSIDE WA 98944 814552945 HOME HEALTH WA 501(C)(3) LINE 3 SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION DBA ASTRIA SUNNYSIDE HOSPITAL 0 AH NPP 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 825080286 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP1 I 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 825058806 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP2 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 825429256 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP3 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 830617866 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP4 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 830998775 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP5 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 831013864 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP6 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 831048852 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP7 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 831072807 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP8 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 831478789 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 SUNNYSIDE HOSPITAL SERVICE CORP 1016 TACOMA AVE SUNNYSIDE WA 98944 474428890 INACTIVE WA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 THE ORGANIZATION'S PARENT DECLARED BANKRUPTCY IN 2019 THAT COMPLICATED THE ACCOUNTING WORK NEEDED TO PREPARE THE ORGANIZATION'S FINANCIAL STATEMENTS. THE SUBSEQUENT COVID-19 PANDEMIC FURTHER DELAYED THE ABILITY OF THE PARENT AND ORGANIZATION TO COMPLETE THE FINANCIAL STATEMENT WORK. STAFFING, ACCOUNTING AND OTHER ISSUES DUE TO THE PANDEMIC, AS WELL AS CATCHING UP ON PRIOR YEAR FILINGS, HAVE CONTINUED UNTIL THE TIME OF FILING. BASED ON THE FACTS EXPLAINED, THE ORGANIZATION REQUESTS THAT THE PENALTY FOR LATE FILING BE REMOVED BASED ON REASONABLE CAUSE.