2022-08-22T10:17:10-05:00 2020-12-31 202609241 White & Company PC 910 Franklin Ave STE 3 Sunnyside WA 98944 990 2020-01-01 911286274 Sunnyside Community Hospital Association SUNN 5098371500 PO Box 719 Sunnyside WA 98944 Maxwell Owens CFO 5098371500 2022-08-22 1 Maxwell Owens 999009999 Thomas White P00181579 5098376700 2022-08-22 X 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z Astria Sunnyside Hospital Maxwell Owens PO Box 719 Sunnyside WA 98944 108831960 0 X www.astria.health X 1985 WA To provide comprehensive quality healthcare to the region. 4 3 649 0 0 0 25732 9134675 109948200 99343725 9220 3957 333099 349603 110316251 108831960 0 0 0 0 0 36825648 0 0 4415 0 52110699 0 88936347 110316251 19895613 109966116 116328999 38961100 44515217 71005016 71813782 To provide comprehensive quality healthcare to the region. 0 0 73072151 99343725 Sunnyside Community Hospital Association (the Association) is comprised of a 25-bed critical access hospital and a series of eight rural health clinics, a Family Birth Center, complete surgical services, laboratory, 4-D obstetrical ultrasound, digital mammography, cardiopulmonary services, registered dietician and diabetes educator services. The Association provided 2,012 Hospital admissions, 66,321 outpatient visits, 12,264 emergency room visits, and 358 births during the year. The Association provides care to persons covered by governmental programs at or below cost and to individuals who are unable to pay. The unreimbursed value of providing care to these patients was $3,893,277 for charity care, $106,551,044 for Medicare, $61,365,434 for Medicaid, and $30,501,211 for other third-party payors for the year. 73072151 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 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 1 1 0 0 0 1 103 0 1 649 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 1 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Maxwell Owens 5098371379 1016 Tacoma Ave Sunnyside WA 98944 X Peggy Brewer President 4.00 1.00 X X 0 0 0 Jonathan Mercer Secretary/Treasurer 4.00 1.00 X X 0 0 0 Ana Garcia Chief of Staff 40.00 1.00 X 320644 0 11558 Cus Artega Vice President 4.00 X 0 0 0 Brian Gibbons CEO 40.00 1.00 X 0 0 0 Michael Long CFO thru 04/2020 40.00 1.00 X 0 0 0 Cynthia Lewis CNO thru 05/2020 40.00 1.00 X 0 0 0 Eric Stokes COO thru 02/2020 40.00 1.00 X 0 0 0 Amber Hunsaker CNO after 05/2020 40.00 1.00 X 68814 0 15674 Valentin Antoci Physician 40.00 X 1060685 0 22208 Tatiana Antoci Physician 40.00 X 613042 0 21252 Peter Grunert Physician 40.00 X 746471 0 11400 Manuel Ybanez Physician 40.00 X 637298 0 38502 David Shoemaker MIS Rep 40.00 1.00 X 577757 0 31329 4024711 0 151923 69 0 1 0 Cardio Solution LLC PO Box 639028 Cincinatti OH 452639028 Cardiology Services 1400000 Aya Healthcare Inc Department 3519 Dallas TX 753123519 Contract Nursing 1332421 Sunnyside Emergency Group A Prof LLC PO Box 677979 Dallas TX 752677979 Purchase Services 1220025 Regional Health dba Astria Health 1016 Tacoma Ave Sunnyside WA 98944 Management Services 995237 Evergreen Anesthesia Associates PO Box 3442 Idaho Falls ID 83403 Purchase Services 882471 28 8981869 152806 9134675 Net Patient Service Revenue 624100 99343725 99343725 99343725 3957 3957 Dietary Revenue 722514 198542 198542 Other Revenue 900099 151061 151061 349603 108831960 99343725 0 353560 X 30905399 25270334 5631279 3786 1009760 825636 183986 138 1911126 1562857 348269 2999363 2361793 637079 491 306248 306248 25615350 18246356 7368994 3083120 1999522 1083598 84424 84424 529120 469862 59258 48749 20155 28594 59551 55047 4504 375394 356709 18685 2846250 2748788 97462 1125829 831353 294476 Medical Supplies & Drug 15179770 15179770 Other Expense 2494087 725731 1768356 Repairs and Maintenance 362807 299310 63497 Indirect Cost Allocatio 0 2034504 -2034504 88936347 73072151 15859781 4415 3054340 6665256 794279 3206 32531148 9181875 1733236 2551590 426145 632665 71360674 40594371 33744607 30766303 2869671 34812690 66528104 109966116 116328999 20215035 20451442 18058121 23432979 687944 630796 38961100 44515217 X 71005016 71813782 71005016 71813782 109966116 116328999 X 19895613 -19086845 -2 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 843512 843512 25610689 16981168 8629521 30971576 23613203 7358373 13934897 13934897 30766303 Other Receivables 65466414 Malpractice insurance reimbursement 625000 Investment in affiliate 436690 66528104 Capital Lease Obligation 5796 Malpractive claims payable 625000 630796 Part X - FIN 48 Footnote The Association is exempt from Federal Income Tax. Accordingly, no provision for income tax is necessary. The Association evaluates uncertain tax positions whereby the effect of the uncertainty would be recorded if the outcome was considered probable and reasonably estimable. As of December 31, 2019 and 2018, the Association had no uncertain tax positions requiring accrual. 1 1 1 X 125.000000000000 1 X 1 1 0 1 1 1119706 1119706 0.01260 40202505 29210939 10991566 0.12360 41322211 29210939 12111272 0.13620 41322211 29210939 12111272 0.13620 1 489 180699 180699 0.00200 2 584 49313 49313 0.00060 3 1073 230012 230012 0.00260 1 2659680 28357321 36512886 -8155565 X 1 1 1 1 Sunnyside Community Hospital PO Box 719 Sunnyside WA 98944 www.astria.health X X X X X Sunnyside Community Hospital 1 0 0 1 X X X X 18 1 1 0 1 X www.astria.health X 1 18 1 www.astria.health 0 1 X 125.000000000000 125.000000000000 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 1 X 0 X X X X 1 X 0 0 Sunnyside Community Hospital Part V, Section B, Line 5: The CHNA was conducted between July 1, 2018, and November 28, 2018. Both quantative and qualitative methods were utilized to gather data about the Astria Health service area. Quantitative Data: A variety of sources were used to identify community health trends and health disparities including but not limited to: iVantage, County Health Rankings, Community Commons, Centers for Disease Control (CDC) BRFSS, Washington State Department of Health, and the Yakima Health District. Every effort was made to obtain the most current data. Data were analyzed for comparison purposes with the United States, Washington State, counties within Washington State, Results Washington, and Healthy People 2020 when comparative data was available. Qualitative Data: Interviews with key stakeholders and a key stakeholder survey were completed. 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. The interviews were completed in-person or by phone between July 1 and August 31, 2018. A total of thirty-five individuals were interviewed. 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. A total of eight-nine (89) surveys were completed. Twenty-seven (27) providers completed the survey including nineteen physicians, six nurse practitioners, and two physician assistants. Representatives of thirteen community organizations completed a total of thrity-one (31) surveys. Governor's Interagency Council on Health Disparities: The Governor's Interagency Council on Health Disparities held a public meeting in Yakima Washington on May 10, 2017. About 40 people were in attendance, including community members, students, and representatives from community-based organizations and from public health, healthcare, and education sectors. Participants were asked about priorities for the community. Feedback from the meeting is included throughout the report.Yakima County Health Care Coalition - Consumer Engagement Survey: The Yakima County Health Care Coalition conducted a community engagment survey from July 1, 2018 - August 31, 2018. There were a total of 501 respondents. Information from the survey is included throughout the report. Astria Health contracted with HealthTechS3 to assist in conducting the 2018 Community Health Needs Assessment. HealthTechS3 is a healthcare consulting and hospital management company based in Brentwood, Tennessee. Carolyn St. Charles, Regional Chief Clinical Officer, was the principal consultant for the project. Sunnyside Community Hospital Part V, Section B, Line 11: Utilizing the prioritization criteria and group discussion, the Senior Leadership Team chose four priority community health needs as focus areas for Astria Health over the next three years: 1)Increase access to Primary Care 2)Increase access to Specialty Care 3)Increase access to Behavioral Health and Substance Abuse services 4)Prevention, screening, and treatment of Chronic Diseases including diabetes and heart disease.The four community health needs are in alignment with the community health needs identified by key stakeholders. The Astria Health priorities will also help to address four of the eight barriers to health identified by the Yakima County Health Care Coalition - Consumer Engagement Survey including: Finding a Health Care Home: Increase access to primary care and Increase access to specialty care. Emotional/Mental Health: Increase access to Behavioral Health services. Substance Abuse and Drugs: Increase access to Substance Abuse Services. Education: Although not addressed specifically, healthcare education is an essential component for accomplishing each of the four priorities chosen by Astria Health. The Hospital continues to provide community education classes on nutrition and fitness and has increased referrals to a registered dietician for weight management counseling.The Hospital continued to increase the number of Medicare patients screened for depression and continues to educate providers on the screening tools. The Hospital began an Intensive Outpatient Program by hiring a midlevel for outpatient services in 2018. Sunnyside Community Hospital Part V, Section B, Line 16j: Notice of the Charity Care Policy shall be posted or prominently displayed within public areas of the Hosptial, and shall be provided to the Responsible Party and explained at the time that Hospital request information with regard to the availability of any third-party coverage. The Policy will be displayed and explained in any language spoken by more than ten percent of the population in the Hospital's service area, and 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.The Charity Care Policy, application, and plain language of application can be at the following url:https://www.astria.health/patients-visitors/policies/ 8 1 - Grandview Medical Center 208 N Euclid Grandview WA 98930 RHC Clinic 2 - Lincoln Avenue Family Medicine 803 E Lincoln Sunnyside WA 98944 RHC Clinic 3 - Valley Internal Medicine 2925 Allen Rd Sunnyside WA 98944 RHC Clinic 4 - Sunnyside Pediatrics 812 Miller Ave Ste C Sunnyside WA 98944 RHC Clinic 5 - John Hughes Student Health Center 1801 East Edison Ave Sunnyside WA 98944 RHC Clinic 6 - Valley Regional RHC V 2705 E Lincoln Ave Sunnyside WA 98944 RHC Clinic 7 - Medical Plaza in Prosser 355 Chardonnay Ave Prosser WA 99350 RHC Clinic 8 - Birch Street Medical Center II 222 E 2nd St Grandview WA 98930 RHC Clinic Part I, Line 7: The Hospital applies the ratio of patient care cost-to-charges for amounts reported in the table (total operating expense less non-patient care activities, total community benefit and total community building expenses). Part II, Community Building Activities: Diabetes education is essential as the lower valley has a high occurence of this condition and many people do not have the necessary information or knowledge to be able to select a balanced and nutritious meal. The diabetes educator and a registered dietician provide one-on-one consultations for patients referred by a doctor in order to educate them on the importance of a balanced and nutritious diet. The consults are primarily for diabetic patients but many are also for weight management issues, cardiac and high blood pressure. A large amount of the weight management consultations are for pediatric weight management, but it requires participation from the entire family. Interpreters are used often for Spanish speaking patients. Many pediatric patients are English speaking, but the parents are Spanish speaking only.The Hospital provides a chaplain service, which is dedicated to serving the needs of the patients, families and staff. The chaplain is committed to offering compassionate spiritual care and emotional support as a resource for healing.The Hospital provided sports physicals at a $10 flat rate to the community. Part III, Line 2: The Hospital used the cost to charge ratio of patient care to determine the cost of bad debt expense. The reason for the negative bad debt number is the result of more patients qualifying for charity adjustment rather than being sent to the collection agencies. 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 eligibilty during the year. The Hospital accounts for discounts and payments on patient accounts in determining bad debts as follows: Payment arrangements include prospectively determined rates per discharge, reimbursed costs, discounted charges, and per diem payments. Net patient service revenue is reported at the estimated net realizable amounts from patients, third party payors, and others for services rendered, including estimated retroactive adjustments under reimbursement agreements with third party payors. 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: Admitting and two self pay counselors visit with patients before they are discharged 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. The most recent community health needs assessment can be found at the following URL:https://www.astria.health/about-us/community-health-needs-assessment/ Part VI, Line 3: The public will be notified by the posting of signs, 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 eligibiltiy for charity care is determined."The latest chartiy care policy is available on our website at the following URL: https://www.astria.health/patients-visitors/policies/ Part VI, Line 4: Sunnyside, Grandview and the rest of the Lower Yakima Valley is a culturally diverse region of nearly 120,000 people living between the City of Yakima on the west and Tri-Cities, Washington on the east. The Hispanic population makes up 74.5% of the population and White Non-Hispanic 22.7% of the population. Many residents in the community experience poverty, food insecurity, lack of transportation, and limited access to affordable housing. Part VI, Line 5: The Board of Directors is comprised of community members representing multiple facets of the community including the medical sector, business managers, education, and local government. 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 amoung 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 abililty to pay. In addition to the charity care program, the Hospital provides or participates in several other programs which contribute to its charitable mission. The Hospital provides community outreach programs including assistance with the purchase of prescribed medications, transportation home for patients discharged from the Hospital and a first aide booth at an annual community event. Part VI, Line 6: Astria Health is the parent non-profit owner of Astria Regional Medical Center, Astria Sunnyside Hospital, and Astria Toppenish Hospital. IRC 501(r) allows hospital organizations with multiple hospital facilities to collaborate and produce one joint CHNA report and implementation strategy for all of its hospital facilities, provided the hospital facilities define their communities to be the same.Astria Regional Medical Center located in Yakima Washington, Astria Sunnyside Hospital located in Sunnyside Washington, and Astria Toppenish Hospital located in Toppenish Washington, define their service area as Yakima County and the communities of Prosser which is in Benton County and Ellensburg which is in Kittitas County. Astria Regional Medical Center, Astria Sunnyside Hospital, and Astria Toppenish Hospital have agreed to produce one CHNA and implementation strategy. The CHNA and Implementation strategy will be reviewed and approved by the governing boards of each hospital, and by the governing board of Astria Health. For the purposes of this document, Astria Regional Medical Center, Astria Sunnyside Hospital, and Astria Toppenish Hospital will be referred to collectively as Astria Health, where applicable. X X 0 0 0 0 0 0 0 0 0 Valentin Antoci Physician 871617 0 184377 0 4691 0 11400 0 10808 0 1082893 0 0 0 Peter Grunert Physician 745811 0 0 0 660 0 11400 0 0 0 757871 0 0 0 Manuel Ybanez Physician 516771 0 117471 0 3056 0 11400 0 27102 0 675800 0 0 0 Tatiana Antoci Physician 292378 0 315973 0 4691 0 10444 0 10808 0 634294 0 0 0 David Shoemaker MIS Rep 376809 0 199336 0 1612 0 15703 0 15626 0 609086 0 0 0 Ana Garcia Chief of Staff 278756 0 41416 0 472 0 11400 0 158 0 332202 0 0 0 Part III - Other Additional Information The organization contracts with Regional Health DBA Astria Health for management services. Astria Health provides management through an agreement with Astria Health Management, Inc. to provide the CEO, CNO, COO and CFO positions for the organization. Astria Health Management, Inc establishes salaries at the time of hire, and periodically reviews them thereafter. In addition to base salary, the CEO, CNO, COO and CFO may be eligible for incentive compensation based on performance parameters established by Astria Health Management Inc. and approved by the Astria Health board. The most recent year in which this process occurred was 2020. Form 990, Part VI, Section A, line 3 The Hospital contracts with Astria Health for management services as listed on Form 990 Part VII Section B Line 1. Form 990, Part VI, Section A, line 6 Astria Health is listed in the Hospital's bylaws as being the sole member of the Hospital. As such, Astria Health has the rights to elect the members of the Hospital's governing body, to approve significant decisions of the governing body, and to receive the Hospital's net assets upon Hospital's dissolution. Form 990, Part VI, Section B, line 11b A copy or the 990 is provided to the 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 the Hospital to do so. The Hospital has a compliance and monitoring policy that is enforced by the CEO. Form 990, Part VI, Section B, line 15 Line 15a - The organization contracts with Astria Health for management services. Astria Health provides management through an agreement with Astria Health Management, Inc. to provide the CEO, CNO, COO and CFO positions for the organization. The salaries are established at the time of hire, and reviewed periodically 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 date for hospitals of similar size and within the revelant geographic are; and c) the Hospital's ability and willingness to pay, as agreed by the Hospital board or a subcomittee thereof. Line 15b - A salary survey is reviewed for key employees by the CEO and HR Director. The CEO makes recommendations to the board who then make the final decision on employment contracts with physicians. Form 990, Part VI, Section C, line 19 The Hospital makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part VII - Additional Information Sunnyside Community Hospital and Sunnyside Community Hospital Foundation share top management officials. The CEO and CFO each devote approximately 39 hours per week to the Hospital and 1 hour per week to the Foundation. Form 990, Part IX, line 11g Other Purchased Services: Program service expenses 18,246,356. Management and general expenses 7,368,994. Fundraising expenses 0. Total expenses 25,615,350. Form 990, Part XI, line 9: Rounding -2. Sunnyside Professional Services LLC PO Box 719 Sunnyside WA 98944 475499567 MOB Mgmt WA 0 436690 Sunnyside Community Hospital Association Sunnyside Hospital Service Corp PO Box 719 Sunnyside WA 98944 474428890 WA Sunnyside Community Hospital Association Sunnyside Community Hospital Home PO Box 719 Sunnyside WA 98944 471344645 WA Sunnyside Community Hospital Association Oxbow Summit LLC PO Box 719 Sunnyside WA 98944 474281366 WA Sunnyside Community Hospital Association Wedded Bliss LLC PO Box 719 Sunnyside WA 98944 475661939 WA Sunnyside Community Hospital Association Kitchen Applicances LLC PO Box 719 Sunnyside WA 98944 475644805 WA Sunnyside Community Hospital Association Home Supply LLC PO Box 719 Sunnyside WA 98944 475634806 WA Sunnyside Community Hospital Association Northwest Health LLC PO Box 719 Sunnyside WA 98944 811978817 WA Sunnyside Community Hospital Association Sunnyside Community Hospital Foundation PO Box 719 Sunnyside WA 98944 912000867 Support WA 501(c)(3) Line 12a, I Sunnyside Community Hospital Association 0 Astria Health 1016 Tacoma Ave Sunnyside WA 98944 813973675 Management WA 501(c)(3) Line 12b, II N/A 0 Sunnyside Home Health DBA Astria Home Health 1016 Tacoma Ave Sunnyside WA 98944 814552945 Healthcare WA 501(c)(3) Line 10 Sunnyside Community Hospital Association 0 SCH Medical Center - Yakima DBA Astria Regional Medical Center 110 S 9th Avenue Yakima WA 98902 814653630 Healthcare WA 501(c)(3) Line 3 Astria Health 0 SHC Medical Center - Toppenish DBA Astria Toppenish Hospital 502 W 4th Avenue Toppenish WA 98948 814670687 Healthcare WA 501(c)(3) Line 3 Astria Health 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 Sunnyside Community Hospital Foundation O 4415 GAAP Accounting The organizations parent declared bankruptcy in 2019 that complicated theaccounting work needed to prepare the organizations financial statements.The subsequent Covid-19 pandemic further delayed the ability of theparent and organization to complete the financial statement work.Staffing, accounting and other issues due to the pandemic have continueduntil the time of filing. Based on the facts explained, the organizationrequests that the penalty for late filing be removed based on reasonablecause.