2022-11-15T15:14:01-06:00 2021-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2021-01-01 910567263 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION YAKI 5095758000 2811 TIETON DRIVE YAKIMA WA 989023799 SUSAN SAUDER VP/CFO 5095758000 2022-11-15 1 SUSAN SAUDER 999009999 COLLEEN RAMIRES P01251320 4252597227 2022-11-15 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CAROLE E PEET 2811 TIETON DRIVE YAKIMA WA 989023799 578496004 0 X WWW.YAKIMAMEMORIAL.ORG X 1950 WA YAKIMA VALLEY MEMORIAL HOSPITAL IS A 226-BED-ACUTE-CARE, NOT-FOR-PROFIT COMMUNITY HOSPITAL THAT HAS SERVED CENTRAL WASHINGTON'S YAKIMA VALLEY FOR NEARLY 70 YEARS. 11 9 3600 141 31115 0 53793088 21432448 466397010 530124263 3667359 2845724 3997024 4306424 527854481 558708859 1172361 911324 0 0 252041978 277499767 0 0 0 257589323 270016439 510803662 548427530 17050819 10281329 446456465 428213458 219303933 175000124 227152532 253213334 X YAKIMA VALLEY MEMORIAL HOSPITAL (YVMH) IS A 226-BED-ACUTE-CARE, NOT-FOR-PROFIT COMMUNITY HOSPITAL THAT HAS SERVED CENTRAL WASHINGTON'S YAKIMA VALLEY FOR NEARLY 70 YEARS. (CONTINUED ON SCHEDULE O) 0 0 301374421 433457367 OUTPATIENT SERVICES. DURING 2021, YAKIMA VALLEY MEMORIAL HOSPITAL (YVMH) PERFORMED 339,845 OUTPATIENT VISITS FOR SURGERY, CANCER CARE, DIAGNOSTIC TESTING AND VARIOUS OTHER THERAPEUTIC SERVICES. THOSE OUTPATIENT SERVICES WERE OFFERED IN A MANNER CONSISTENT WITH THE HOSPITAL'S 501(C)(3) STATUS, INCLUDING CHARITY CARE TO QUALIFYING PATIENTS PER THE HOSPITAL'S CHARITY CARE POLICY. IN 2021, YVMH PROVIDED CHARITY CARE FOR 33,237 OUTPATIENT VISITS, TOTALING $26,344,071. (CONTINUED ON SCHEDULE O.)YVMH'S ONCOLOGY PROGRAMS DELIVERED CHARITY CARE SERVICES 2,222 TIMES IN 2021. CHILDREN'S VILLAGE, BASED IN YAKIMA, IS A CLINIC THAT PROVIDES HEALTHCARE SERVICES FOR CHILDREN WITH SPECIAL NEEDS. THE FACILITY ALSO HOUSES THE NURSE FAMILY PARTNERSHIP, A PROGRAM THAT PROVIDES SPECIALLY TRAINED NURSES TO HELP FIRST-TIME MOTHERS DURING PREGNANCY AND UNTIL THE CHILD'S SECOND BIRTHDAY. THESE PROGRAMS PROVIDED THE CHARITY CARE AND UNREIMBURSED MEDICAL SERVICES. MATERNAL HEALTH SERVICES PROVIDES COMMUNITY-BASED PROGRAMS AND SERVICES FOCUSED ON PROVIDING PREVENTATIVE HEALTH AND EDUCATION FOR FAMILIES THROUGHOUT CENTRAL WASHINGTON. YVMH'S PAIN MANAGEMENT CLINIC SAW 836 PATIENT ENCOUNTERS WHICH FELL UNDER YVMH'S CHARITY CARE CRITERIA. MEMORIAL'S 'OHANA CLINIC PROVIDES BREAST HEALTH EDUCATION, SCREENING AND DIAGNOSTIC MAMMOGRAPHY, AND BREAST CARE COORDINATION FOR WOMEN IN THE YAKIMA VALLEY. CHARITY CARE FUNDED 792 ENCOUNTERS WITH 'OHANA PROVIDERS IN 2021. YVMH PROVIDED 1,528 PATIENT ENCOUNTERS WITH CHARITY CARE IN OUTPATIENT SURGERY IN 2021. YAKIMA VALLEY MEMORIAL'S WOUND MANAGEMENT SERVICES COMBINES TRADITIONAL PRACTICES AND MEDICINES FOR WOUND HEALING WITH TECHNOLOGY, SUCH AS HYPERBARIC OXYGEN THERAPY. THESE SERVICES ARE OFFERED TO PATIENTS WHO HAVE UNDERGONE 30 DAYS OF CONVENTIONAL WOUND TREATMENT WITHOUT SIGNIFICANT IMPROVEMENT. IN 2021, 178 OF THOSE ENCOUNTERS WERE PERFORMED UNDER CHARITY CARE ASSISTANCE. WITH ONE OF THE BUSIEST EMERGENCY DEPARTMENTS IN THE STATE OF WASHINGTON, OUR PROVIDERS ARE TRAINED IN EMERGENCY MEDICINE AND TREATED 83,559 PATIENTS A YEAR REGARDLESS OF AGE, CULTURE, EMPLOYMENT, ETHNICITY, EXPRESSION, GENDER IDENTITY, LANGUAGE, NATIONAL ORIGIN, PARTICIPATION IN PROGRAMS, PHYSICAL OR MENTAL DISABILITY, RACE, COLOR, RELIGION, SERVICES AND ACTIVITIES, SEX, SEXUAL ORIENTATION, SOCIOECONOMIC STATUS, OR FINANCIAL STATUS. THE EMERGENCY DEPARTMENT PROVIDES FORPATIENTS' EMERGENT NEEDS; AND, ALL PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT ARE EXAMINED BY A TRAINED PROVIDER. YVMH'S EMERGENCY DEPARTMENT EXPERIENCED 7,365 PATIENT ENCOUNTERS WITH CHARITY CARE RECIPIENTS IN 2021, FOR A TOTAL OF $11,865,731. YAKIMA VALLEY MEMORIAL SERVED 20,316 CHARITY CARE PATIENTS WITH ADDITIONAL OUTPATIENT SERVICES. THESE SERVICES INCLUDE: CARDIAC REHAB, EDUCATION, INFUSION CARE, LABORATORY, PHYSICIAN'S OFFICES, OUTPATIENT PROCEDURES, PRE-PROCEDURE TESTING, SLEEP STUDIES, THERAPY, X-RAY AND IMAGING, AND CARDIOVASCULAR CARE. 114210477 96517924 INPATIENT SERVICES. YAKIMA VALLEY MEMORIAL HOSPITAL (YVMH) HOSPITAL ADMITTED 803 PATIENTS THAT QUALIFIED FOR CHARITY CARE, FOR A TOTAL OF 3,642 PATIENT DAYS. THESE INPATIENT CHARITY CARE ENCOUNTERS AMOUNTED TO $2,961,880. CHARITY CARE WAS PROVIDED PER THE TERMS OF THE HOSPITAL'S CHARITY CARE POLICY. INPATIENT SERVICES INCLUDES OBSTETRICS & GYNECOLOGY (OBGYN), PEDIATRICS, PSYCHIATRIC SERVICES, EMERGENCY DEPARTMENT (ED), HOSPITAL IMAGING, HOSPITAL-BASED PHYSICIAN SERVICES, CRITICAL CARE, ORTHOPEDICS, CARDIOVASCULAR CARE, CANCER CARE, ANESTHESIOLOGY, RESPIRATORY THERAPY, AND PHARMACY. (CONTINUED ON SCHEDULE O.)IN 2021, YVMH'S OB/GYN DEPARTMENT PROVIDED CHARITY CARE TO PATIENTS FOR PRE-DELIVERY TESTING AND OBSTETRIC EMERGENCY CARE. YVMH'S INPATIENT PSYCHIATRIC SERVICES TREATS ADULT PATIENTS FOR A BROAD SPECTRUM OF MENTAL HEALTH CONCERNS INCLUDING DEPRESSION, ANXIETY, ADJUSTMENT DISORDERS, ADD/ADHD, AND MAJOR PSYCHIATRIC ILLNESS. INPATIENT PSYCHIATRIC SERVICES ALSO OFFERS PSYCHIATRIC EVALUATION AND MEDICATION MANAGEMENT, IN ADDITION TO TREATMENT OF UNDERLYING MEDICAL CONDITIONS. 14532905 911324 117207 SUPPORTING SERVICE. YAKIMA VALLEY MEMORIAL PROVIDES ADDITIONAL SUPPORTIVE SERVICES TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY THAT DO NOT DIRECTLY ALIGN AS EITHER INPATIENT OR OUTPATIENT SERVICES. THESE SUPPORTIVE SERVICES WERE OFFERED IN A MANNER CONSISTENT WITH THE HOSPITAL'S 501(C)(3) STATUS. THESE SUPPORTIVE SERVICES INCLUDE EDUCATIONAL SERVICES FOR STUDENT PHYSICIANS, NURSES, AND ALLIED HEALTH PROFESSIONALS, SUPPORT OF THE COMMUNITY HEALTH OF CENTRAL WASHINGTON (CHCW) MEDICAL RESIDENCY PROGRAM (25 RESIDENTS), A PRE-SURGERY CLINIC, NURSING FLOAT POOL, BUSINESS DEVELOPMENT, AND INFORMATION TECHNOLOGY AND SYSTEMS. 6039958 650 YAKIMA VALLEY MEMORIAL PROVIDES COMMUNITY HEALTH EDUCATION, SUPPORT, AND SERVICES TO RESIDENTS OF YAKIMA COUNTY. THESE PROGRAMS ALIGN WITH INITIATIVES AND DISPARITIES OUTLINED WITHIN OUR PUBLISHED COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY HEALTH PROGRAMS SERVED 7,391 RESIDENTS IN 2021 AND EQUATED TO $528,760 IN COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS EXPENDITURES. YAKIMA VALLEY MEMORIAL PARTNERED WITH THE LOCAL YMCA TO DELIVER "ACTIVELY CHANGING TOGETHER", A CHILDHOOD OBESITY PROGRAM THAT ASSISTED 81 FAMILIES. DIABETES PREVENTION AND DIABETES WELLNESS PROGRAMS WERE ALSO OFFERED TO 96 COMMUNITY MEMBERS DURING THE YEAR. IN ADDITION TO CAMPAIGNS TARGETING OBESITY AND DIABETES, YVMH CREATED ACCESS TO FREE ZUMBA AND YOGA CLASSES FOR 6,084 ADULTS AND CHILDREN AS PART OF AN ANNUAL "HEALTHY FOR LIFE" CAMPAIGN. IN ADDITION TO SUPPORTING COMMUNITY HEALTH INITIATIVES, YVMH ALSO SUPPORTS COMMUNITY INVESTMENT/BUILDING ACTIVITIES BY MAKING SEVERAL CONTRIBUTIONS TO NOT-FOR-PROFIT CAUSES THROUGHOUT YAKIMA COUNTY THAT ALIGN WITH OUR COMMUNITY HEALTH NEEDS ASSESSMENT EQUALING TO $843,075 IN DONATIONS. YAKIMA UNION GOSPEL MISSION MEDICAL CLINIC WAS THE RECIPIENT OF $100,000 FOR CLINIC SUPPORT. THE MISSION SERVES OVER 12,000 PATIENTS FREE OF CHARGE EVERY YEAR, HELPING TO STEM OVERUTILIZATION OF EMERGENCY DEPARTMENT RESOURCES AND HELPING TO PROVIDE ADDITIONAL PRIMARY CARE ACCESS TO THE UNDERSERVED. THE YAKIMA COUNTY DEVELOPMENT ASSOCIATION/NEW VISION RECEIVED $30,000 FOR COMMUNITY DEVELOPMENT INITIATIVES. THE YAKIMA FAMILY YMCA WAS IN THE PROCESS OF CONSTRUCTING A NEW AQUATIC FACILITY THAT WILL HELP AT-RISK KIDS AND YAKIMA VALLEY MEMORIAL WAS ABLE TO CONTRIBUTE $125,000 TOWARD CONSTRUCTION AND THE DEVELOPMENT OF REHABILITATION SERVICES. 6039958 650 436157761 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 0 0 0 1 238 0 1 3600 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SUSAN SAUDER VPCFO 5095758000 2811 TIETON DRIVE YAKIMA WA 989023799 DAVID HARGREAVES DIRECTOR/CHAIRMAN 2.00 X X 0 0 0 BUFFY ALEGRIA DIRECTOR/VICE CHAIRMAN 2.00 X X 0 0 0 RICH MARTINEZ DIRECTOR/TREASURER 2.00 X X 0 0 0 SONIA RODRIGUEZ TRUE DIRECTOR/SECRETARY 2.00 X X 0 0 0 BRUCE HEISER DIRECTOR 2.00 X 0 0 0 MARIBEL JIMENEZ DIRECTOR 2.00 X 0 0 0 STEVE RUPP MD DIRECTOR 2.00 X 0 0 0 GAIL WEAVER DIRECTOR 2.00 X 0 0 0 JIM YOUNG DIRECTOR 2.00 X 0 0 0 KERRY HARTHCOCK MD DIRECTOR 2.00 X 0 0 0 CYNTHIA JUAREZ DIRECTOR 2.00 X 0 0 0 CAROLE PEET PRESIDENT/CEO 40.00 X 653525 0 26598 TIMOTHY REED VICE PRESIDENT/CFO (THRU 7/21) 40.00 X 628651 0 35814 THOMAS MCDONAGH VICE PRESIDENT/CFO 40.00 X 243979 0 14313 SUSAN SAUDER VICE PRESIDENT/CCO 40.00 X 245267 0 24722 WILLIAM M BRUEGGERMAN VICE PRESIDENT/CMO 40.00 X 577519 0 46097 SHAWNIE HAAS VICE PRESIDENT/SPECIALTY SERVICES 40.00 X 311174 0 42903 LORI GREEN VICE PRESIDENT/CNO/COO 40.00 X 345383 0 19193 MOHAN ASHOK KUMAR MD PHYSICIAN 40.00 X 929937 0 13246 SIVA MANNEM MD PHYSICIAN 40.00 X 653247 0 45348 CHATT JOHNSON MD PHYSICIAN 40.00 X 617361 0 11635 ADARSH BHARDWAJ MD PHYSICIAN 40.00 X 604324 0 10771 MATT G SILVA MD PHYSICIAN 40.00 X 578197 0 46101 SCOTT LANCASTER FORMER KEY EMPLOYEE 40.00 X 398615 0 45213 6787179 0 381954 570 1 1 0 EMERGENCY ASSOCIATES OF YAKIMA 2811 TIETON DRIVE YAKIMA WA 98902 MEDICAL AND HEALTHCARE 19021287 VK POWELL PO BOX 10295 YAKIMA WA 98909 CONSTRUCTION 7831861 COMMUNITY HEALTH OF CENTRAL WASHINGTON 501 S 5TH AVENUE YAKIMA WA 98902 MEDICAL AND HEALTHCARE 7102833 FOCUSONE SOLUTIONS LLC PO BOX 850861 MINNEAPOLIS MN 554850861 AGENCY STAFFING 5992206 COMPHEALTH ASSOCIATES INC PO BOX 97265 DALLAS TX 753972625 LOCUMS 3740224 112 18859933 2572515 230415 21432448 NET PATIENT REVENUE 621400 526412260 526412260 MEMORIAL PHYSICIANS/SIGNAL HEALTH 621110 2501329 2501329 EXPENSE REIMBURSEMENT 900099 1179559 1179559 LAB SERVICE 621500 31115 31115 530124263 1275737 1275737 736599 831137 -94538 -94538 -94538 20509395 16600 18953993 2015 1555402 14585 1569987 1569987 CAFETERIA 900099 1565351 1565351 CHILD CARE 624410 1018409 1018409 GIFT SHOP 453220 12721 12721 1804481 1804481 4400962 558708859 530093148 31115 7152148 X 911324 911324 3215140 2411355 803785 443828 332871 110957 229398478 194285045 35113433 12017780 10167423 1850357 15950640 13520256 2430384 16473901 13937442 2536459 2951530 18500 2933030 300100 300100 106716 106716 308308 308308 81362238 68359272 13002966 53791 20837 32954 15078706 10891928 4186778 22198072 13777943 8420129 12180091 7833253 4346838 99902 53884 46018 1552995 1552995 19996488 1785297 18211191 3912189 1812729 2099460 DRUGS 45385210 45349922 35288 MEDICAL SUPPLIES 44223489 43788733 434756 BAD DEBT EXPENSE 5773184 5773184 DIETARY SUPPLIES 1995115 540553 1454562 12538315 586010 11952305 548427530 436157761 112269769 0 63565867 70872775 40208709 37994060 56248610 71095472 1747830 3020595 9848980 9760381 4601016 5292451 316086455 119591920 194756310 196494535 43521064 4018630 3123684 4252439 1009266 603091 27825129 24809029 446456465 428213458 99018698 78158853 55900387 41935650 33898292 33813084 0 168028 6000000 0 24486556 20924509 219303933 175000124 X 223756780 249693038 3395752 3520296 227152532 253213334 446456465 428213458 X 10281329 2151826 13627647 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 106716 106716 0 PART II-B, LINE 1: YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PAYS MEMBERSHIP DUES TO WASHINGTON STATE HOSPITAL ASSOCIATION AND AMERICAN HEALTHCARE ASSOCIATION, PORTIONS OF WHICH WERE USED FOR LEGISLATIVE AND LOBBYING ACTIVITIES. YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION ALSO PAYS MEMBERSHIP DUES TO OTHER PROFESSIONAL HEALTH CARE ORGANIZATIONS, A PORTION OF WHICH MAY BE USED FOR LEGISLATIVE AND LOBBYING ACTIVITIES. 0 1 X 14785769 14785769 99622579 23554635 76067944 6785018 3193197 3591821 174495183 91088582 83406601 20397906 1755506 18642400 196494535 RIGHT OF USE ASSET 20265595 OTHER INVESTMENTS - 457B PLAN 3834614 DUE FROM AFFILIATES 708820 24809029 LEASE LIABILITIES 20924509 20924509 X PART IV, LINE 2B: THE MEDICAL STAFF FUND IS MAINTAINED ON BEHALF YVMH BUT IS NOT OWNED BY YVMH. PART X, LINE 2: U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. THE DEPARTMENT OF REVENUE IS CURRENTLY AUDITING SALES AND USE TAX FOR YEARS 2016 THRU 2018. THE ORGANIZATION'S MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2015. 1 1 X 1 X 1 X 1 1 0 0 8064261 0 8064261 0.01490 133265167 93006731 40258436 0.07420 0 0 141329428 93006731 48322697 0.08910 7 7904 2226015 821065 1404950 0.00260 5 308 7158292 633888 6524404 0.01200 3 9443 12590730 10849169 1741561 0.00320 1 1525 403754 0 403754 0.00070 1 138300 0 138300 0.00030 17 19180 22517091 12304122 10212969 0.01880 17 19180 163846519 105310853 58535666 0.10790 1 172875 172875 0.00030 1 110504 110504 0.00020 1 4 37004 37004 0.00010 3 4 320383 320383 0.00060 1 9409587 0 134736450 136791905 -2055455 X 1 1 1 58 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION 2811 TIETON DRIVE YAKIMA WA 98902 YAKIMAMEMORIAL.ORG X X X X YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIAT 1 0 0 1 X X X X X X X X X X 19 1 0 0 1 X SEE PART V X X 1 20 1 SEE PART V 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 3J: MEMORIAL'S 2019 COMMUNITY HEALTH NEEDS ASSESSMENT WAS ADOPTED BY THE BOARD OF DIRECTORS ON OCTOBER 15, 2019. THE REPORT WAS MADE PUBLIC ON THE WEBSITE AND PRINTED COPIES MADE AVAILABLE AT THE HOSPITAL UPON REQUEST. THE AREAS OF ASSESSMENT IN THE 2019 REPORT ARE: DEMOGRAPHICS; SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH (INCLUDING - EDUCATION, HEALTH LITERACY, UNEMPLOYMENT, INCOME POVERTY, CHILDREN ELIGIBLE FOR FREE SCHOOL LUNCH, FOOD INSECURITY, HOUSING AFFORDABILITY, HOUSEHOLDS WITHOUT A CAR, DISABILITY STATUS, HOMELESSNESS, SAFETY, CRIME AND VIOLENCE); CLINICAL CARE (INCLUDING - ACCESS TO HEALTH SERVICES, UNINSURED POPULATION, COST BARRIERS TO CARE, CLINICAL PREVENTIVE SERVICES); HEALTH OUTCOMES (INCLUDING - CHRONIC DISEASE PROFILE, MORTALITY, QUALITY OF LIFE); LEADING HEALTH INDICATORS (INCLUDING - HEALTH BEHAVIORS, MATERNAL, INFANT AND CHILD HEALTH, REPRODUCTIVE SEXUAL HEALTH, MENTAL HEALTH, INJURY AND HOSPITALIZATION); PHYSICAL ENVIRONMENT (INCLUDING - AIR POLLUTION, ACCESS TO LOCATIONS FOR PHYSICAL ACTIVITY, TRANSPORTATION, SEVERE HOUSING PROBLEMS). ADDITIONAL ASSESSMENTS ARE CONDUCTED ON AN ONGOING BASIS TO TRACK NEEDS SUCH AS CDC COVID DATA TRACKER. DATA SOURCES USED ARE: INTERNAL, US CENSUS, BRFSS, HEALTH YOUTH SURVEY, DEPARTMENT OF HEALTH, CANCER REGISTRY AND MANY OTHER PUBLIC DATA SOURCES. DISPARITY GAPS WERE IDENTIFIED WHEN COMPARING THE STATE OF WASHINGTON TO YAKIMA COUNTY. FURTHERMORE, WHEN DATA WAS AVAILABLE, INDICATORS WERE STRATIFIED BY AGE, SEX AND RACE ETHNICITY IN ORDER TO IDENTIFY DISPARITIES IN HEALTH OUTCOMES. MEMORIAL'S ACTIONS AND PROGRESS IN ADDRESSING THE PRIORITY AREAS IDENTIFIED IN THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT (2016) ARE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN THE 2017-2019 PRIORITY AREA UPDATE SECTION ON PAGE 87. YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: INPUT FOR DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS SOLICITED THROUGH AN ONLINE TOOL. THE INTERNAL ADVISORY COMMITTEE SELECTED THE TOP TEN AREAS OF GREATEST NEED AND THROUGH THE SURVEY COMMUNITY ORGANIZATIONS COULD PROVIDE INPUT ON THE CHNA. THE TEN AREAS OF GREATEST NEED WERE: ACCESS TO HEALTH CARE; HEALTH EQUITY; CHRONIC DISEASE PREVENTION & MANAGEMENT; MENTAL HEALTH; HEALTH BEHAVIORS-PHYSICAL INACTIVITY & NUTRITION; ADVERSE CHILDHOOD EXPERIENCE (ACES); SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH; SAFETY AND CRIME; HOMELESSNESS; AND SUBSTANCE ABUSE. THE SURVEY ASKED RESPONDENTS TO RANK EACH OF THE TEN PRIORITY AREAS IN ORDER OF IMPORTANCE TO BOTH THEM AS A COMMUNITY MEMBER, AS WELL AS TO THE ORGANIZATION THEY REPRESENT. WE DID NOT LIMIT RESPONSES BUT SENT OUT THE REQUEST TO TAKE THE SURVEY TO AS MANY PARTNERS IN THE COMMUNITY AS POSSIBLE AND ALSO ASKED THAT THEY FORWARD ON TO ANY OTHER PARTNERS THEY FELT SHOULD BE INVOLVED. WE ALLOWED THREE WEEKS FOR RESPONSES. FEEDBACK WAS RECEIVED FROM OVER 60 ORGANIZATIONS SPANNING DIFFERENT SECTORS INCLUDING: STATE, LOCAL AND TRIBAL HEALTH DEPARTMENTS; HEALTH CARE PROVIDERS, INCLUDING SPECIALTY SERVICES SUCH AS MENTAL HEALTH; COMMUNITY-BASED ORGANIZATIONS, COALITIONS, AND GROUPS REPRESENTING MEMBERS OF THE UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS IN THE COMMUNITY; CHURCHES AND FAITH-BASED ORGANIZATIONS; BUSINESSES; THE SCHOOL DISTRICT; COMMUNITY COLLEGES AND UNIVERSITIES; LOCAL GOVERNMENT; AND INDIVIDUAL HEALTH EXPERTS WITHIN THE COMMUNITY. A FULL LIST OF PARTNERS IS INCLUDED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AND CAN BE FOUND ON MEMORIAL'S WEBSITE: WWW.YAKIMAMEMORIAL.ORG/ABOUT-US-COMMUNITY-BENEFITS.ASP/. THE TOP THREE PRIORITY AREAS CHOSEN BY THE COMMUNITY WERE: ACCESS TO HEALTH CARE; HEALTH EQUITY; AND MENTAL HEALTH. MEMORIAL'S SENIOR LEADERSHIP REVIEWED THE FINAL FIVE PRIORITY AREAS RANKED BY THE COMMUNITY AND NARROWED DOWN THE FOCUS TO THE FINAL THREE: ACCESS TO HEALTH CARE; HEALTH EQUITY; AND MENTAL HEALTH, BASED ON ORGANIZATIONAL RESOURCES AND ABILITY TO ADDRESS THE AREA OF NEED. YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 7D: IN ADDITION TO BEING MADE PUBLICLY AVAILABLE ON THE WEBSITE, THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT WAS SHARED WIDELY BY EMAIL AND MADE PUBLIC THROUGH COMMUNITY-BASED ORGANIZATIONS, COALITIONS AND GROUPS. YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: MEMORIAL HAS OUTLINED IN THE VIRGINIA MASON MEMORIAL IMPLEMENTATION PLAN 2020-2022 HOW THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THE IMPLEMENTATION PLAN IS A MULTI-YEAR GUIDE TO IMPROVING THE HEALTH STATUS OF OUR COMMUNITY AND TARGETS THE PRIORITIZED AREAS AND GAPS IN HEALTH NEEDS THAT HAVE BEEN IDENTIFIED. THROUGH THE FOLLOWING FOUR-STAGE APPROACH WE WILL MAKE PROGRESS TOWARD IMPROVED HEALTH AND TRANSFORMING YAKIMA: PLAN - IDENTIFY PRIORITIES FOR SERVICES AND COMMUNITY HEALTH IMPROVEMENT PROCESSES; PARTNER - IDENTIFY THOSE WHO CAN WORK TOGETHER TO BEST MEET COMMUNITY NEEDS; DO - DESIGN PROGRAMS AND APPROACHES TO IMPROVE ACCESS TO HIGH QUALITY HEALTH CARE SERVICES; AND IMPROVE - IMPROVE THE HEALTH OUTCOMES OF YAKIMA COUNTY. AS A RESULT OF THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, HEALTH PRIORITIES WERE SELECTED AND USING OUR FOUR-STAGE APPROACH WE HAVE DEVELOPED AN ACTION PLAN OUTLINED IN THE IMPLEMENTATION PLAN TO ADDRESS THE THREE PRIORITIES AND POSITIVELY INFLUENCE THE HEALTH AND WELL-BEING OF THE COMMUNITY. THE VIRGINIA MASON MEMORIAL IMPLEMENTATION PLAN OUTLINES BOTH INTERNAL AND COMMUNITY-WIDE OBJECTIVES AND STRATEGIES UNDER EACH OF THE PRIORITY AREAS AS WELL AS SPECIFIC MEASUREMENTS THAT WILL BE USED TO EVALUATE OUR PROGRESS. THE VIRGINIA MASON MEMORIAL IMPLEMENTATION PLAN 2020-2022 WAS ADOPTED BY THE MEMORIAL BOARD OF DIRECTORS ON MAY 13, 2020. ALL THREE PRIORITIES IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ARE BEING ADDRESSED.MEMORIAL IDENTIFIED THREE PRIORITY AREAS IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE PRIORITY AREAS INCLUDE: ACCESS TO CARE; HEALTH EQUITY; AND MENTAL HEALTH. "ACCESS TO CARE": MEMORIAL FACILITATES THE EDUCATION OF PATIENTS, EMPLOYEES, AND COMMUNITY MEMBERS ON ACCESSING WASHINGTON STATE HEALTH BENEFITS EXCHANGE. WE ARE WORKING WITH PARTNERS AS PART OF THE GREATER COLUMBIA ACCOUNTABLE COMMUNITY OF HEALTH TO EXPLORE DEVELOPMENT OF A REGIONAL HEALTH IMPROVEMENT COLLABORATIVE AND STRATEGY. WE HAVE INSTITUTED A NUMBER OF INTERNAL INITIATIVES TO IMPROVE ACCESS FOR MEDICAID PATIENTS TO PRIMARY CARE AND SPECIALTY CLINICS, AS WELL AS REDUCE WAIT TIME. IN ADDITION, WE PROVIDE FINANCIAL SUPPORT AND PARTNER WITH UNION GOSPEL MISSION MEDICAL CARE CENTER FREE CLINIC, WHICH IS FOCUSED ON PROVIDING ACCESS TO PRIMARY CARE, LAB, IMAGING, AND SPECIALTY SERVICES FOR UNINSURED/UNDERINSURED POPULATION. WE PARTNER WITH, AND FINANCIALLY SUPPORT LOCAL COMMUNITY COLLEGES AND HEALTH PROFESSION EDUCATION PROGRAMS. MEMORIAL MENTORS AND TRAINS ON SITE LOCAL HEALTH PROFESSIONALS FROM COLLEGE PROGRAMS ACROSS THE COUNTY AND STATE. THIS ALLOWS STUDENTS TO PRACTICE IN THEIR RESPECTIVE FIELD OF STUDY AS REQUIRED TO COMPLETE THEIR DEGREE AND SIT FOR ASSOCIATED EXAMS. AFTER TRAINING AND COMPLETION OF COURSE WORK EACH HEALTH PROFESSIONAL IS READY FOR THE WORKFORCE AND TO FILL MUCH NEEDED VACANCIES WITHIN THE COMMUNITY. MEMORIAL ALSO PROVIDES A NUMBER OF OPPORTUNITIES FOR CONTINUING MEDICAL EDUCATION PROGRAMMING EACH YEAR TO SERVE MEDICAL PROFESSIONALS ACROSS THE COMMUNITY, ALLOWING THEM TO RENEW LICENSES AND CONTINUE TO PRACTICE IN YAKIMA COUNTY. MEMORIAL HAS ESTABLISHED COMMUNITY EDUCATION AND PREVENTION PROGRAMS FOR THE TOP FOUR DISEASE STATES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THEY ARE: CARDIOVASCULAR DISEASE, CANCER, DIABETES AND OBESITY. THESE COMMUNITY EDUCATION AND PREVENTION CLASSES ARE ALL OFFERED IN BOTH SPANISH AND ENGLISH AND INCLUDE: DIABETES PREVENTION EDUCATION, ACT! GET UP, GET MOVING! CHILDHOOD OBESITY PROGRAM, COOKING, AND EXERCISE CLASSES. IN ADDITION, WE REALIZE THAT MANY UNINSURED AND UNDERINSURED POPULATIONS EXPERIENCE GREATER ACCESS ISSUES, AND WE HAVE DEVELOPED A STRATEGY FOCUSED ON CARE COORDINATION POST EMERGENCY DEPARTMENT VISITS. LASTLY, IN 2020 DUE TO COVID19, MEMORIAL PROVIDED ACCESS TO COVID TESTING AND VACCINES BY SETTING UP COMMUNITY CLINICS ACROSS THE COUNTY. "HEALTH EQUITY": MEMORIAL IS WORKING ON STRATEGIES TO IMPROVE THE COLLECTION OF DEMOGRAPHIC DATA (E.G. RACE, ETHNICITY AND PREFERRED LANGUAGE). WE DEVELOPED AN EQUITY TRAINING PATHWAY PLAN, WHICH INCLUDES CULTURAL HUMILITY TRAINING AND WORKING WITH SPECIAL POPULATION, IN ADDITION TO BOARD OF DIRECTOR AND EXECUTIVE LEADERSHIP RACIAL EQUITY TRAINING. WE HAVE TAKEN THE AMERICAN HOSPITAL ASSOCIATION'S HEALTH EQUITY PLEDGE WITH THE GOAL OF DISCOVERING AND PRIORITIZING MEANINGFUL DIFFERENCES IN CARE, OUTCOMES, AND EXPERIENCE ACROSS PATIENT GROUPS, AND DEVELOP STRATEGIES TO ELIMINATE HEALTH DISPARITIES. SYSTEMS LEVEL WORK INCLUDE: HAVING VIDEO REMOTE INTERPRETATION UNITS IN EVERY CLINIC AND FLOOR IN THE HOSPITAL, AND IN EVERY PATIENT ROOM IN THE EMERGENCY ROOM, TO ASSURE ACCESS TO QUALIFIED INTERPRETERS; ALL STAFF THAT PROVIDE INTERPRETATION OR COMMUNICATE WITH A PATIENT IN ANOTHER LANGUAGE ARE ASSESSED FOR THEIR LANGUAGE PROFICIENCY; INTENTIONAL WORK AROUND BUILDING GOVERNANCE, LEADERSHIP AND WORKFORCE THAT REFLECTS THE COMMUNITY WE SERVE IS BEING EVALUATED BY WAY OF A WORKFORCE DATA ANALYTICS; AND WE ARE LEVERAGING COMMUNITY PARTNERS FOR GREATER COLLECTIVE IMPACT. DURING COVID19 WE ASSURED THAT EDUCATION, PRESS CONFERENCES, AND TESTING AND VACCINE INFORMATION WAS ALL AVAILABLE IN SPANISH. WE ALSO USED DATA TO ANALYZE EQUAL ACCESS TO PRIMARY AND SPECIALTY CARE TELEHEALTH VISITS BY LANGUAGE PREFERENCE, AND ASSURED PROVIDERS HAD INTERPRETERS AVAILABLE DURING VIRTUAL VISITS. "MENTAL HEALTH": MEMORIAL HAS ESTABLISHED INTERVENTION STRATEGIES TO PROMOTE MENTAL WELL-BEING AND PREVENT MENTAL HEALTH DISORDERS. "NURSE FAMILY PARTNERSHIPS (NFP)" IS AN EVIDENCE-BASED NURSE HOME VISITATION PROGRAM THAT ENROLLS FIRST-TIME LOW-INCOME MOTHERS EARLY IN THEIR PREGNANCY AND FOLLOWS THEM THROUGHOUT THEIR CHILD'S SECOND BIRTHDAY. NFP HAS BEEN EXPANDED TO THE YAKAMA NATION IN COLLABORATION WITH TTAWAXT, A MULTI-AGENCY COLLABORATIVE EFFORT LED BY INDIAN HEALTH SERVICES ON THE YAKAMA RESERVATION, OF WHICH MEMORIAL IS A PARTNER IN, TO INVESTIGATE AND REDUCE INFANT MORTALITY AND PROMOTE HEALTHY FAMILIES WITHIN TRIBAL COMMUNITIES. THE GOAL OF NFP IS TO IMPROVE CHILD HEALTH AND DEVELOPMENT BY HELPING PARENTS PROVIDE RESPONSIBLE AND COMPETENT CARE FOR THEIR CHILDREN. NFP BUILDS ON PARENTS' SELF-EFFICACY AND STRONG EMOTIONAL AND PHYSICAL ATTACHMENT TO THEIR BABIES. FURTHERMORE, FAMILIES' ECONOMIC SELF-SUFFICIENCY IS IMPROVED BY HELPING PARENTS DEVELOP A VISION FOR THEIR OWN FUTURE, PLAN FUTURE PREGNANCIES, CONTINUE THEIR EDUCATION AND FIND WORK. "MATERNAL CHILD HEALTH" IS A PERINATAL MENTAL HEALTH SUPPORT FOR WOMEN EXPERIENCING POSTPARTUM ANXIETY AND DEPRESSION, THAT TEACHES PROTECTIVE FACTORS TO PREVENT ADVERSE CHILDHOOD EXPERIENCES (ACE'S) AND BUILDS AWARENESS OF COMMUNITY RESOURCES. "HOLISTIC MENTAL HEALTH COUNSELING" SUPPORT AND THERAPEUTIC INTERVENTIONS TO PATIENTS, FAMILIES AND CAREGIVERS IS A PROGRAM PROVIDED DURING CRISIS, TRAUMA, AND END-OF-LIFE. "ACUTE CARE PSYCHIATRIC SERVICES" PROVIDE COMPLEX MEDICAL CARE FOR PSYCHIATRIC DISORDERS, AND IMPROVED COMMUNITY ACCESS, INCORPORATING EVIDENCE BASED PHYSICAL FITNESS TREATMENT IN AN ACUTE CARE SETTING. THE REMAINING TOP AREAS OF GREATEST NEED WHERE NOT SELECTED BECAUSE OTHERS IN THE COMMUNITY ARE ADDRESSING THESE, AND DUE TO FINANCIAL CONSTRAINTS. THE VIRGINIA MASON MEMORIAL IMPLEMENTATION PLAN 2020-2022 CAN BE FOUND ON OUR WEBSITE: WWW.YAKIMAMEMORIAL.ORG/ABOUT-US-COMMUNITY-BENEFITS.ASP/. PART V, SECTION B, LINE 7A: HOSPITAL FACILITY'S WEBISTE: WWW.YAKIMAMEMORIAL.ORG/ABOUT-US-COMMUNITY-BENEFITS.ASP/ PART V, LINE 16A-16C: THE FAP, FAP APPLICATION AND FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND ONLINE AT: WWW.YAKIMAMEMORIAL.ORG/PATIENTS-AND-VISITORS-FINANCIAL-ASSISTANCE-GUIDELINES.ASP/ 32 1 - NORTH STAR LODGE 808 N 39TH AVENUE YAKIMA WA 98902 CANCER TREATMENT FACILITY 2 - VALLEY IMAGING 314 S 11TH AVENUE YAKIMA WA 98902 RADIOLOGY 3 - YAKIMA VALLEY HOME HEALTH 302 S 10TH AVENUE YAKIMA WA 98902 HOME HEALTH AND HOSPICE 4 - PHYSICIANS ANESTHESIA 406 S 30TH AVE STE 202 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 5 - YMH HEART AND VASCULAR 406 S 30TH AVENUE SUITE 101 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 6 - OHANA 1515 W YAKIMA AVENUE YAKIMA WA 98902 MAMMOGRAPHY 7 - RIDGEVIEW SURGERY 2500 RACQUET LANE STE 150 YAKIMA WA 98902 OUTPATIENT SURGERY CENTER 8 - ORTHOPEDICS NORTHWEST 1211 N 16TH AVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 9 - MEMORIAL PHYSICIANS LAB 4003 CREEKSIDE LOOP YAKIMA WA 98908 MEDICAL LABORATORY 10 - GENERATIONS OBGYN 3003 TIETON DRIVE STE 230 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 11 - PAIN CENTER - WATER'S EDGE 1460 N 16TH AVENUE SUITE D YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 12 - YAKIMA UROLOGY ASSOC AT MEMORIAL TRUST 2500 RACQUT LANE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 13 - LAKEVIEW SPINE 1470 N 16TH AVENUE YAKIMA WA 98902 THERAPY 14 - YAKIMA GASTROENTEROLOGY ASSOCIATES 3909 CREEKSIDE LOOP SUITE 120 YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 15 - FAMILY MEDICINE OF YAKIMA 504 N 40TH AVENUE YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 16 - YAKIMA EAR NOSE AND THROAT 1601 CREEKSIDE LOOP YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 17 - CASCADE SURGICAL PARTNERS 3003 TIETON DRIVE STE 300 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 18 - MEMORIAL SLEEP SPECIALISTS 406 S 30TH AVE SUITE 206 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 19 - YGA AMBULATORY SURGERY 3909 CREEKSIDE LOOP SUITE 120 YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 20 - MEMORIAL CORNERSTONE MEDICINE 4003 CREEKSIDE LOOP YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 21 - PULMONOLOGY 406 S 30TH AVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 22 - PACIFIC CREST FAMILY MEDICINE 311 S 72ND AVENUE YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 23 - APPLE VALLEY FAMILY MEDICINE 1008 S 38TH AVENUE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 24 - SELAH FAMILY MEDICINE 620 N PARK DRIVE SELAH WA 98942 OUTPATIENT PHYSICIAN CLINIC 25 - YAKIMA VASCULAR ASSOCIATES 406 S 30TH AVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 26 - ZILLAH FAMILY MEDICINE 616 RAILROAD AVENUE SUITE 12 ZILLAH WA 98953 OUTPATIENT PHYSICIAN CLINIC 27 - HEALTHY NOW WEST VALLEY 120 S 72ND AVE SUITE 102 YAKIMA WA 98908 URGENT CARE 28 - HEALTHY NOW - 40TH 3909 CREEKSIDE LOOP SUITE 130 YAKIMA WA 98902 URGENT CARE 29 - MEMORIAL OUTPATIENT PSYCH 3909 CREEKSIDE LOOP STE 115 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 30 - YAKIMA ENDOCRINOLOGY ASSOCIATES 3909 CREEKSIDE LOOP STE 115 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 31 - YAKIMA PODIATRY ASSOCIATES 1607 CREEKSIDE LOOP SUITE 140 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 32 - YGA HISTOLOGY 3909 CREEKSIDE LOOP SUITE 120 YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: FAP INDICATES MAY WRITE OFF AS CHARITY CARE, AMOUNTS FOR PATIENTS WITH FAMILY INCOME IN EXCESS OF 300% OF THE FEDERAL POVERTY LEVEL WHEN CIRCUMSTANCES INDICATE SEVERE FINANCIAL HARDSHIP OR PERSONAL LOSS. 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. PART I, LN 7 COL(F): BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 IS BASED ON TRUING UP THE BAD DEBT RESERVES ON THE BALANCE SHEET. PART I, LINE 6A: WASHINGTON STATE DOES NOT REQUIRE THAT NON-PROFIT HOSPITALS PREPARE A COMMUNITY BENEFIT REPORT OR MAKE IT AVAILABLE TO THE PUBLIC. MEMORIAL HAS NOT PREPARED AND PUBLISHED A 2021 COMMUNITY BENEFIT REPORT. PART II, COMMUNITY BUILDING ACTIVITIES: ECONOMIC DEVELOPMENT OPPORTUNITIES ARE PROVIDED THROUGH "COMMUNITY BUILDING DONATIONS" WHICH CONSIST OF DONATIONS MADE TO COMMUNITY ORGANIZATIONS TO PROMOTE ECONOMIC DEVELOPMENT IN THE YAKIMA VALLEY; INCLUDING DONATIONS MADE TO YAKIMA COUNTY DEVELOPMENT ASSOCIATION TO SUPPORT NEW SMALL BUSINESS VENTURES IN THE YAKIMA VALLEY AND SUPPORT OF THE NEW YMCA FACILITY IN YAKIMA. "YOUTHWORKS" IS A YOUTH EMPOWERMENT AND COMMUNITY SERVICE INITIATIVE ENGAGING YOUTH DIRECTLY THROUGH MENTORING, VOLUNTEERING, AND PHILANTHROPY, WHILE PROMOTING COMMUNITY HEALTH IMPROVEMENT ADVOCACY. "NON-HEALTH PROFESSION EDUCATION" FACILITATES WORKFORCE DEVELOPMENT BY PROVIDING ON THE JOB TRAINING FOR STUDENTS IN NON-CLINICAL FIELDS AT VARIOUS DEPARTMENTS ACROSS THE HOSPITAL. THESE INCLUDE: BUSINESS SERVICES (BILLING AND CODING), HUMAN RESOURCES, AND INFORMATION TECHNOLOGY. PART III, LINE 2: MEMORIAL USED ACTUAL BAD DEBT WRITES OFFS PER THE PATIENT BILLING SYSTEM TO CALCULATE THE AMOUNT ON LINE 2. PART III, LINE 4: OUR FINANCIAL STATEMENTS INCLUDE A FOOTNOTE REGARDING NET PATIENT REVENUE (PAGES 13-14) AND INCLUDES DETAILS ON CONTRACTUAL ALLOWANCES. AS BAD DEBT IS NOT MATERIAL TO THE FINANCIAL STATEMENTS, THERE IS NOT VERBIAGE SPECIFIC TO BAD DEBT, ACCOUNTS RECEIVABLE OR ALLOWANCES FOR DOUBTFUL ACCOUNTS. THE ORGANIZATION DOES RECORD AN ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH ARE NETTED WITH ACCOUNTS RECEIVABLES ON THE FINANCIAL STATEMENTS. BAD DEBT IS NETTED WITH PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS IN A SIMILAR FASHION AS CONTRACTUAL ALLOWANCES ARE. 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. MEMORIAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT ON LINE 6. OUR FINANCIAL STATEMENTS INCLUDE A FOOTNOTE REGARDING UNCOLLECTIBLE ACCOUNTS WHICH ARE REPORTED AS AN OFFSET TO PATIENT REVENUE. PART III, LINE 9B: DURING THE ADMITTANCE PROCESS AT MEMORIAL, ALL PATIENTS ARE PROVIDED WITH THE HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION. ELIGIBILITY FOR ASSISTANCE IS DETERMINED UPON ADMISSION TO THE HOSPITAL, AND ELIGIBLE PATIENTS ARE NOT BILLED FOR SERVICES. PART VI, LINE 2: MEMORIAL CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, THE TWO MOST RECENT REPORTS CAN BE FOUND AT WWW.YAKIMAMEMORIAL.ORG/ABOUT-US-COMMUNITY-BENEFITS.ASP/. IN ADDITION, THE HOSPITAL ROUTINELY LOOKS AT HEALTH CARE INDICATORS FROM COUNTY HEALTH RANKINGS, US CENSUS, HEALTHY YOUTH SURVEY, WASHINGTON STATE DEPARTMENT OF HEALTH, AND OTHER SOURCES TO ASSIST WITH PROGRAM PLANNING AND DEVELOPMENT OF COMMUNITY BENEFIT PROGRAMS. INTERNAL DATA IS ALSO ANALYZED FOR DEVELOPMENT AND QUALITY IMPROVEMENT OF COMMUNITY BENEFIT HEALTH PROGRAMS. THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS ADOPTED BY THE MEMORIAL BOARD OF DIRECTORS ON OCTOBER 15, 2019, AND IT IS PUBLICLY AVAILABLE. PART VI, LINE 3: MEMORIAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE MEMORIAL'S CHARITY CARE POLICY AT VARIOUS POINTS BEGINNING WITH SCHEDULING AND CONTINUING THROUGH THE PATIENT BILLING PROCESS. THE FOLLOWING LANGUAGE, OR A CLOSE VARIATION, IS INCLUDED IN OUR GUIDE TO PATIENT SERVICES, "UNDERSTANDING YOUR HOSPITAL BILL" BROCHURE, PUBLIC SIGNAGE AT THE MAIN AND EMERGENCY DEPARTMENT ENTRANCES, AS WELL AS ON OUR PATIENT STATEMENTS: "YAKIMA VALLEY MEMORIAL HOSPITAL PROVIDES CHARITY CARE IN ACCORDANCE WITH RCW 70.170.060. APPLYING FOR MEDICAL ASSISTANCE WITH DSHS IS A PREREQUISITE TO A CHARITY CARE DETERMINATION OF ELIGIBILITY. PLEASE CONTACT PATIENT ACCOUNTS IF YOU WOULD LIKE TO APPLY FOR CHARITY OR HAVE QUESTIONS REGARDING MEMORIAL'S CHARITY CARE PROGRAM. AND/OR "THE HOSPITAL IS ABLE TO PROVIDE FREE OR DISCOUNTED CARE FOR ALL OR PART OF YOUR HOSPITAL BILLS IF YOU QUALIFY, BASED ON YOUR INCOME. PLEASE REQUEST A CHARITY CARE APPLICATION, FILL IT OUT COMPLETELY, AND PROMPTLY RETURN IT TO BUSINESS SERVICES." WE ALSO CONTRACT WITH CARDON OUTREACH TO SCREEN ALL SELF-PAY AND CONTRACT CARE PATIENTS FOR MEDICAID ELIGIBILITY AND ASSIST THEM WITH COMPLETING ALL OF THE PREREQUISITE PAPERWORK, ETC. IF A PATIENT IS NOT ELIGIBLE FOR ASSISTANCE AND CANNOT PAY, CARDON PROVIDES THE PATIENT WITH A CHARITY CARE APPLICATION. PART VI, LINE 4: YAKIMA COUNTY IS COMPOSED OF PRIMARILY RURAL COMMUNITIES (14 CITIES AND TOWNS) IN CENTRAL WASHINGTON, SPANNING 4,311 SQUARE MILES. TOTAL CURRENT POPULATION FOR YAKIMA COUNTY AS OF 2022 IS 259,950. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 56.6 PERSONS PER SQUARE MILE, IS LESS THAN THE NATIONAL AVERAGE POPULATION DENSITY OF 93.8 PERSONS PER SQUARE MILE. THE PRIMARY SERVICE AREA (PSA) OF YAKIMA VALLEY MEMORIAL HOSPITAL IS COMPRISED OF YAKIMA COUNTY. SECONDARY SERVICE AREAS (SSA) FOR HIGHLY SPECIALIZED PROGRAMS AND SERVICES (E.G. CHILDREN'S VILLAGE) STRETCHES INTO NEIGHBORING COUNTIES INCLUDING KITTITAS AND KLICKITAT. LOCATED WITHIN YAKIMA COUNTY IS THE YAKAMA NATION RESERVATION WHICH IS OVER 1.3 MILLION ACRES AND REACHES ACROSS THE CASCADES. YAKIMA COUNTY CONSISTS OF 50% MALE AND 50% FEMALE POPULATION. NEARLY HALF (47%) OF THE POPULATION IS MARRIED, WHILE 33.3% REPORT NEVER BEING MARRIED, AND THE REMAINING 19.7% CONSISTS OF RESIDENTS WHO ARE MARRIED BUT SEPARATED (3%), DIVORCED (11%) OR WIDOWED (5.7%). YAKIMA COUNTY IS HOME TO APPROXIMATELY 10,000 MIGRANT AND SEASONAL FARMWORKERS AND THEIR DEPENDENTS. THE PERCENTAGE OF THE POPULATION LIVING IN URBAN AREAS IS 76.5% COMPARED WITH 24% LIVING IN RURAL AREAS, WHICH IS A HIGHER PROPORTION OF RURAL POPULATION THAN BOTH NATIONAL AND WASHINGTON STATE AVERAGES 81% VS. 19% AND 84% VS. 16%, RESPECTIVELY. YAKIMA COUNTY CONSISTS OF A 66.6% MEDICARE/MEDICAID PAYER MIX (16.7% MEDICARE AND 49.9% MEDICAID). ACCORDING TO THE WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES 42.4% OF THE POPULATION IS RECEIVING ECONOMICAL SERVICES ASSISTANCE, PRIMARILY FOR: CHILD SUPPORT SERVICES, CHILDCARE, AND BASIC FOOD PROGRAMS. OUR COMMUNITY IS COMPRISED OF 50.2% PERSONS OF HISPANIC OR LATINO ORIGIN AND 42.3% OF PERSONS OF WHITE NON-HISPANIC OR LATINO ORIGIN, AND 6.7% AMERICAN INDIAN AND ALASKA NATIVE. 16.7% OF PERSONS LIVING AT POVERTY LEVEL, 7.2% ARE UNEMPLOYED, 16.3% UNINSURED PRE-COVID19 (17.6% UNINSURED WEEK ENDING 8/8/20). PART VI, LINE 5: MEMORIAL IS COMMITTED TO LEADING, FACILITATING, PARTNERING, AND PROMOTING THE HEALTH OF CENTRAL WASHINGTON. THE PROMOTION OF COMMUNITY HEALTH IS ACCOMPLISHED THROUGH COLLABORATIONS, RESEARCH-BASED EDUCATION AND INTERVENTIONS FOCUSED ON DISPARITY ELIMINATION AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH. SURPLUS FUNDING IS USED TO PROVIDE OVERSIGHT, PROGRAM PLANNING AND EVALUATION; AS WELL AS DIRECT CARE TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS THROUGH CHILDREN'S VILLAGE, AND PROMOTION OF WELL-BEING THROUGH EVIDENCE-BASED COMMUNITY HEALTH PROGRAMMING. THIS INCLUDES CHRONIC HEALTH ISSUES AND OTHER RISK FACTORS THAT CONTRIBUTE TO POOR HEALTH OUTCOMES. MEMORIAL HAS DEDICATED STAFF, CONTRACTORS, AND FTE POSITIONS TO ACCOMPLISH THE DEVELOPMENT, PLANNING AND INTERVENTIONS TO ADDRESS COMMUNITY NEEDS. MEMORIAL BUDGETS SURPLUS FUNDS TO ALLOW CONTINUING SUPPORT OF EDUCATION THROUGH PARTNERSHIPS WITH PACIFIC NORTHWEST UNIVERSITY, CENTRAL WASHINGTON FAMILY PRACTICE RESIDENCY, OBSTETRICAL EDUCATION AND ENSURING MEMORIAL HAS THE STAFF TO SUPPORT OUR COMMUNITIES' EDUCATION NEEDS. FUNDS ARE ALSO USED TO ENSURE THAT WE HAVE THE FACILITIES AND EQUIPMENT TO MEET THE GREATEST NEEDS OF THE COMMUNITY; EXAMPLES INCLUDE: HEALTHY NOW CLINICS, EXPANDING THE INPATIENT PSYCHIATRIC DEPARTMENT AND COTTAGE IN THE MEADOW FOR END OF LIFE CARE. TO MEET THE ACCESS NEEDS OF THE COMMUNITY MEMORIAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WITHIN THE COMMUNITY WHO APPLY TO ITS MEDICAL STAFF, AND ALLIED HEALTH STAFF AND WHO MEET QUALIFICATIONS SET FORTH IN THE MEDICAL STAFF'S BYLAWS, RULES AND REGULATIONS, POLICIES AND SPECIFIC DEPARTMENTAL PRIVILEGING DOCUMENTS. FOR THE MOST CRITICAL SHORTAGES, PARTICULARLY WITHIN SPECIALTY AREAS MEMORIAL EXTENDS THE PRIVILEGES TO PHYSICIANS OUTSIDE OF THE COMMUNITY TO MEET THE NEED.THE MAJORITY OF MEMORIAL'S GOVERNING BODY CONSISTS OF PERSONS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL: YAKIMA COUNTY; NO MEMBERS OF THE GOVERNING BODY ARE CONSIDERED EMPLOYEES OR INDEPENDENT CONTRACTORS. 1 YAKIMA FAMILY YMCA 5 NORTH NACHES AVE YAKIMA WA 98901 910568717 501(C)(3) 125000 0 TO HELP BUILD A NEW BRANCH BUILDING YAKIMA UNION GOSPEL MISSION 1300 N FIRST STREET YAKIMA WA 98901 237050061 501(C)(3) 100000 0 MEDICAL CARE CENTER OPERATIONS YAKIMA COUNTY DEVELOPMENT ASSOCIATION PO BOX 1387 YAKIMA WA 98907 911284283 501(C)(6) 30000 0 TO HELP IN THE DEVELOPMENT OF THE YAKIMA AREA THE MEMORIAL FOUNDATION 3111 TIETON DRIVE YAKIMA WA 98902 911022358 501(C)(3) 656324 0 GENERAL SUPPORT 3 1 PART I, LINE 2: MEMORIAL SUPPORTS PROGRAMS OR ACTIVITIES THAT DEMONSTRATE A COMMUNITY BENEFIT, ARE CONSISTENT WITH THE OBJECTIVES OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT, SUPPORT THE VALUES OF THE HOSPITAL AND IMPROVE HEALTH IN AND AROUND YAKIMA COUNTY. MEMORIAL TRACKS ALL COMMUNITY BENEFIT/COMMUNITY INVESTMENT ACTIVITIES. MEMORIAL REQUIRES ALL RECIPIENTS OF COMMUNITY INVESTMENT DOLLARS TO REPORT THE IMPACT MADE BY THE FUNDING. THIS IS SPECIFICALLY STIPULATED IN A LETTER THAT ACCOMPANIES ANY MEMORIAL MONIES WHICH REQUESTS THAT RECIPIENTS PROVIDE INFORMATION ON HOW THE AWARD WAS USED AND THE SPECIFIC OUTCOMES THEY WERE ABLE TO ADDRESS OR IMPACT AS A RESULT OF THE FUNDING. RECIPIENTS ARE ASKED TO SUPPLY THAT INFORMATION TO MEMORIAL'S COMMUNITY HEALTH DIVISION. THE COMMUNITY HEALTH TEAM FOLLOWS UP REGULARLY ON THOSE REQUESTS AND KEEPS DOCUMENTED RECORDS OF RECEIPT. X X X X X 1 0 0 0 0 0 0 1 0 MOHAN ASHOK KUMAR MD PHYSICIAN 614426 0 313070 0 2441 0 0 0 13246 0 943183 0 0 0 SIVA MANNEM MD PHYSICIAN 431441 0 218144 0 3662 0 17049 0 28299 0 698595 0 0 0 CAROLE PEET PRESIDENT/CEO 511776 0 138112 0 3637 0 15238 0 11360 0 680123 0 0 0 TIMOTHY REED VICE PRESIDENT/CFO (THRU 7/21) 176246 0 74333 0 378072 0 17951 0 17863 0 664465 0 0 0 CHATT JOHNSON MD PHYSICIAN 616461 0 0 0 900 0 11635 0 0 0 628996 0 0 0 MATT G SILVA MD PHYSICIAN 528897 0 45634 0 3666 0 18852 0 27249 0 624298 0 0 0 WILLIAM M BRUEGGERMAN VICE PRESIDENT/CMO 511715 0 62602 0 3202 0 18481 0 27616 0 623616 0 0 0 ADARSH BHARDWAJ MD PHYSICIAN 537394 0 64913 0 2017 0 0 0 10771 0 615095 0 0 0 SCOTT LANCASTER FORMER KEY EMPLOYEE 366579 0 29400 0 2636 0 17164 0 28049 0 443828 0 0 0 LORI GREEN VICE PRESIDENT/CNO/COO 330127 0 13866 0 1390 0 1301 0 17892 0 364576 0 0 0 SHAWNIE HAAS VICE PRESIDENT/SPECIALTY SERVICES 264112 0 44108 0 2954 0 21813 0 21090 0 354077 0 0 0 SUSAN SAUDER VICE PRESIDENT/CCO 221474 0 22075 0 1718 0 10552 0 14170 0 269989 0 0 0 THOMAS MCDONAGH VICE PRESIDENT/CFO 206149 0 35000 0 2830 0 0 0 14313 0 258292 0 0 0 PART I, LINE 4A TIMOTHY REED RECEIVED A SEVERANCE PAYMENT OF $375,889 IN 2021. PART I, LINE 7 VARIABLE COMPENSATION AMOUNTS ARE CALCULATED BASED OFF OF THE RESULTS OF THE STRATEGIC SCORECARD AS WELL AS THE EMPLOYEE'S INDIVIDUAL EVALUATION. THIS IS THEN MULTIPLIED BY THE EMPLOYEES' GROSS EARNINGS FOR THE PREVIOUS YEAR. THIS IS APPROVED BY THE YAKIMA VALLEY MEMORIAL HOSPTIAL (MEMORIAL) EXECUTIVE COMMITTEE, AND DOCUMENTED IN ITS MINUTES. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HRJ6 2016-11-10 34208306 BUILDING AND EQUIPMENT 0 0 0 A 34766320 2519359 678328 31216887 2019 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 FORM 990, SCHEDULE K, PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS/MARKET VALUE FLUCTUATIONS. FORM 990, SCHEDULE K, PART IV, LINE 2C: (A) ISSUER NAME: WASHINGTON HEALTH CARE FACILITIES AUTH DATE THE REBATE COMPUTATION WAS PERFORMED: 10/31/2021 JUAN JIMENEZ FAMILY MEMBER OF MARIBEL JIMENEZ, DIRECTOR 100821 EMPLOYMENT 0 JORGE GARCIA FAMILY MEMBER OF CYNTHIA JUAREZ, DIRECTOR 92279 EMPLOYMENT 0 BREAN MILLS GARCIA FAMILY MEMBER OF CYNTHIA JUAREZ, DIRECTOR 76196 EMPLOYMENT 0 X VENTILATORS 1 230415 FAIR MARKET VALUE 0 0 0 PART I, COLUMN (B): NUMBER OF CONTRIBUTIONS. FORM 990, PART III, LINE 1 YVMH'S PURPOSE IS TO INSPIRE PEOPLE TO THRIVE. THE HOSPITAL DOES THIS BY UPHOLDING THE VALUES OF RESPECT, ACCOUNTABILITY, TEAMWORK, STEWARDSHIP AND INNOVATION. BY HELPING PATIENTS ACHIEVE HEALTH, WE ALSO CREATE HEALTHY COMMUNITIES. YVMH HAS A MULTISPECIALTY TEAM OF MORE THAN 300 PHYSICIANS, OFFERING PRIMARY AND SPECIALTY CARE, CONVENIENCE CARE CLINICS, AS WELL AS OPERATING ONE OF THE REGION'S BUSIEST EMERGENCY DEPARTMENTS. OUR NETWORK OF CLINICS SURROUNDS THE YAKIMA VALLEY, AND EXTENDS NORTHWEST INTO ELLENSBURG AND SOUTHEAST TO SUNNYSIDE. YAKIMA VALLEY MEMORIAL HOSPITAL ALSO OPERATES COTTAGE IN THE MEADOW, A 24-HOUR, 20-BED INPATIENT HOSPICE FACILITY WHICH SERVES THE ENTIRE YAKIMA VALLEY. WE ALSO COLLABORATE TO OPERATE CHILDREN'S VILLAGE, A CLINIC THAT SERVES CHILDREN WITH SPECIAL AND DEVELOPMENTAL HEALTHCARE NEEDS AND THEIR FAMILIES, AND GARDEN VILLAGE, A SKILLED NURSING FACILITY, PROVIDING THE HIGHEST LEVEL OF COMFORT-DRIVEN, QUALITY CARE TO THOSE WITH COMPLEX AND LONG-TERM MEDICAL AND PSYCHIATRIC NEEDS. YAKIMA VALLEY MEMORIAL HOSPITAL FUNDS THE CENTRAL WASHINGTON FAMILY MEDICINE RESIDENCY PROGRAM (CWFMR), A 30 RESIDENT FAMILY MEDICINE RESIDENCY PROGRAM, IN ADDITION TO OFFERING TRAINING PROGRAMS FOR NURSING, PHARMACY, RESPIRATORY THERAPY, PHYSICAL THERAPY, AND LABORATORY TECHNOLOGY. FORM 990, PART VI, SECTION A, LINE 1A THE GOVERNING BODY DELEGATES TO AN EXECUTIVE COMMITTEE COMPRISED OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE CORPORATION TO ACT ONLY IN TIME SENSITIVE OR EMERGENCY SITUATIONS AS DETERMINED BY THE EXECUTIVE COMMITTEE, SUCH AUTHORITY TO BE EXERCISED IN TIME PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE GOVERNING BODY OF THE CORPORATION. THE EXECUTIVE COMMITTEE DOES NOT HAVE THE AUTHORITY TO AMEND, ALTER OR REPEAL THE BYLAWS, ELECT, APPOINT OR REMOVE ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE CORPORATION; AMEND THE ARTICLES OF INCORPORATION; ADOPT A PLAN OF MERGER OR ADOPT A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION; AUTHORIZE THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKE PROCEEDINGS THEREFORE; ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION; AMEND, ALTER OR REPEAL ANY RESOLUTION OF THE BOARD WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTER OR REPEALED BY THE EXECUTIVE COMMITTEE; OR TERMINATE THE CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO PERIODICALLY EVALUATES THE EFFECTIVENESS OF MEMORIAL'S SYSTEMS FOR RESOLVING INTERNAL CONFLICTS. THE BOARD ALSO DELEGATES TO THE EXECUTIVE COMMITTEE THE AUTHORITY OF THE BOARD TO MAKE ALL APPOINTMENTS AND REAPPOINTMENTS TO THE MEDICAL STAFF OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 4 MEMORIAL'S ARTICLES OF INCORPORATION AND BYLAWS HAVE BEEN AMENDED AND RESTATED TO REMOVE VIRGINIA MASON HEALTH SYSTEM AS MEMORIAL'S SOLE CORPORATE MEMBER EFFECTIVE JANUARY 1, 2021. FORM 990, PART VI, SECTION B, LINE 11B THE YVMH AUDIT AND COMPLIANCE COMMITTEE ("ACC"), A COMMITTEE COMPOSED OF INDEPENDENT COMMUNITY MEMBERS HAS BEEN DELEGATED RESPONSIBILITY FOR OVERSIGHT OF THE ANNUAL FORM 990 PREPARATION PROCESS INCLUDING 1) SELECTION, ENGAGEMENT, AND PERFORMANCE OF AN INDEPENDENT TAX PREPARER; 2) REVIEW OF THE ANNUAL DRAFT FORM 990 AND 990-T TAX RETURNS, AND 3) RECOMMENDING THE FINAL FORM 990 AND 990-T TAX RETURNS FOR REVIEW TO THE MEMORIAL BOARD OF DIRECTORS. ANNUALLY, AT THE NOVEMBER MEETING, MANAGEMENT AND THE TAX PREPARER PROVIDES THE ACC WITH AN INITIAL DRAFT OF THE FORM 990 AND PRESENT AN OVERVIEW OF THE FORM 990 PREPARATION PROCESS. THE FINAL DRAFT FORM 990 IS REVIEWED BY THE ACC FOLLOWED BY A BOARD REVIEW OF THE FINAL FORM 990 PRIOR TO FILING. THE FINAL FORM 990 AND 990-T TAX RETURNS ARE PROVIDED TO EACH MEMBER OF THE MEMORIAL BOARD OF DIRECTORS VIA ELECTRONIC DELIVERY. FORM 990, PART VI, SECTION B, LINE 12C THE YVMH GOVERNANCE COMMITTEE HAS ACCOUNTABILITY FOR OVERSIGHT OF THE PROCESS FOR DISCLOSURE, EVALUATION AND MANAGEMENT OF CONFLICTS OF INTEREST INVOLVING ANY MEMBER OF THE BOARD, EXECUTIVE LEADERSHIP OR KEY EMPLOYEES ("COVERED PERSON"). PURSUANT TO THE CONFLICTS OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED TO ALL COVERED PERSONS. IN ADDITION, A COVERED PERSON HAS AN ON-GOING DUTY TO DISCLOSE THE EXISTENCE OF A CONFLICT OF INTEREST AT ANY TIME AN ACTUAL OR POTENTIAL CONFLICT ARISES. EACH COVERED PERSON IS REQUIRED UPON APPOINTMENT AND ANNUALLY THEREAFTER TO ATTEST TO A STATEMENT THAT AFFIRMS THAT SUCH PERSON HAS 1) RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT MEMORIAL IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ITS TAX-EXEMPT PURPOSES. WRITTEN DISCLOSURES ARE REVIEWED BY THE GOVERNANCE COMMITTEE TO DETERMINE IF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS AND IF SO, HOW IT SHOULD BE MANAGED. THE COVERED PERSON IS INFORMED IN WRITING REGARDING THE DETERMINATION (THE "CONFLICT OF INTEREST MANAGEMENT PLAN"). NO COVERED PERSON WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL ENGAGE IN AN ACTIVITY ON MEMORIAL'S BEHALF RELATED TO THE DISCLOSED ACTUAL OR POTENTIAL CONFLICT OF INTEREST UNLESS SUCH ACTIVITY IS PERMITTED BY THE CONFLICT OF INTEREST MANAGEMENT PLAN OR UNTIL THE COVERED PERSON HAS UNDERTAKEN ALL STEPS SET FORTH IN THE MANAGEMENT PLAN TO MANAGE, REDUCE OR ELIMINATE THE CONFLICT. ALL COVERED PERSONS HAVE A DUTY TO DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO MEETING AGENDA ITEMS. THE CONFLICTS OF INTEREST POLICY REQUIRES THAT COPIES OF THE CONFLICT OF INTEREST QUESTIONNAIRE BE COMPLETED ANNUALLY BY EACH COVERED PERSON AND ANY CONFLICT OF INTEREST MANAGEMENT PLAN BE MAINTAINED. IN ADDITION, THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL DOCUMENT THE DISCLOSURE AND RESOLUTION OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST DISCLOSED AT SUCH MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE YAKIMA VALLEY MEMORIAL HOSPITAL (MEMORIAL) EXECUTIVE COMMITTEE, A COMMITTEE COMPOSED SOLELY OF INDEPENDENT DIRECTORS NONE OF WHOM HAVE A CONFLICT OF INTEREST, IS ACCOUNTABLE FOR SETTING REASONABLE TOTAL COMPENSATION PACKAGES FOR EACH MEMORIAL EXECUTIVE, INCLUDING THE CEO, OFFICERS AND KEY EMPLOYEES ("EXECUTIVES") CONSISTENT WITH MEMORIAL'S PHILOSOPHY AND PRINCIPLES. THE COMMITTEE DEVELOPS AND APPROVES ANNUAL GOALS AND PERFORMANCE CRITERIA WHICH ARE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION OPPORTUNITIES FOR THE MEMORIAL EXECUTIVES. THE COMMITTEE ASSESSES PERFORMANCE AGAINST THESE GOALS. THE COMMITTEE SELECTS AND ENGAGES A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO REVIEW AND ANALYZE THE TOTAL COMPENSATION AND BENEFITS PACKAGES TO THE EXECUTIVES. THE COMMITTEE AS PART OF ITS ANALYSIS OBTAINS FROM THE COMPENSATION CONSULTANT APPROPRIATE COMPARABILITY DATA INCLUDING TOTAL COMPENSATION PAID BY SIMILARLY SITUATED NON-PROFIT HEALTH CARE ORGANIZATIONS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE TO EACH OF THE EXECUTIVE POSITIONS. WITH RESPECT TO THOSE EXECUTIVES BELOW THE LEVEL OF CHIEF EXECUTIVE OFFICER, THE COMMITTEE REQUESTS THAT THE CHIEF EXECUTIVE OFFICER WORK WITH THE COMPENSATION CONSULTANT TO FORMULATE A COMPENSATION RECOMMENDATION FOR EACH SUCH EXECUTIVE, CONSISTENT WITH MEMORIAL'S COMPENSATION PHILOSOPHY AND PRINCIPLES. CONSISTENT WITH MEMORIAL'S COMPENSATION PHILOSOPHY AND PRINCIPLES, THE COMMITTEE APPROVES TOTAL COMPENSATION PACKAGES FOR EACH OF THE EXECUTIVES BASED ON INFORMATION PRESENTED TO THE COMMITTEE, REASONABLENESS AND THE BEST INTERESTS OF MEMORIAL. THE COMMITTEE'S DECISIONS REGARDING COMPENSATION FOR EACH EXECUTIVE ARE DOCUMENTED IN WRITTEN RESOLUTIONS AND MINUTES OF THE COMMITTEE. THE COMMITTEE PROMPTLY REPORTS ITS ACTION TO THE BOARD WHOSE REPORTS ARE REFLECTED IN THE BOARD'S MINUTES. THE COMMITTEE SHARES AND THE BOARD REVIEWS AND APPROVES COMPENSATION FOR MEMORIAL'S CEO. THE EXECUTIVES THAT WERE REVIEWED IN 2021 WERE: CHIEF EXECUTIVE OFFICER AND VICE PRESIDENTS, CHIEF INFORMATION OFFICER, CHIEF NURSING/OPERATIONS OFFICER, CHIEF MEDICAL OFFICER, PHYSICIAN EXECUTIVE MEDICAL GROUP, SPECIALTY SERVICES, COMPLIANCE OFFICER, FOUNDATION, AND MEDICAL GROUP OPERATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES, BYLAWS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G LABORATORY: PROGRAM SERVICE EXPENSES 6,201,456. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,201,456. CLINIC SERVICES: PROGRAM SERVICE EXPENSES 5,558,992. MANAGEMENT AND GENERAL EXPENSES 13,588. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,572,580. EMERGENCY DEPARTMENT SERVICES: PROGRAM SERVICE EXPENSES 13,438,367. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,438,367. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,149,288. MANAGEMENT AND GENERAL EXPENSES 2,449,456. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,598,744. ORTHOPEDIC SERVICES: PROGRAM SERVICE EXPENSES 11,613,619. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,613,619. AGENCY: PROGRAM SERVICE EXPENSES 8,228,879. MANAGEMENT AND GENERAL EXPENSES 190,815. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,419,694. OUTSIDE PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 9,009,634. MANAGEMENT AND GENERAL EXPENSES 8,931,064. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,940,698. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 10,159,037. MANAGEMENT AND GENERAL EXPENSES 1,418,043. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,577,080. FORM 990, PART XI, LINE 9: CHANGE IN PENSION OBLIGATION 13,627,647. MEMORIAL PHYSICIANS 3800 SUMMITVIEW YAKIMA WA 98902 264379419 MEDICAL SERVICES WA -6445 949 YVMHA CENTRAL WASHINGTON HEALTHCARE PARTNERS 3800 SUMMITVIEW YAKIMA WA 98902 453483343 ACCOUNTABLE CARE ORGANIZATION WA 2507774 159823 YVMHA YAKIMA UROLOGY AT MEMORIAL TRUST 2811 TIETON DRIVE YAKIMA WA 98902 476620487 MEDICAL SERVICES WA 5145052 690621 YVMHA ORTHOPEDICS NORTHWEST AT MEMORIAL TRUST 1211 N 16TH AVENUE YAKIMA WA 98902 826150143 MEDICAL SERVICES WA 10071313 479569 YVMHA YAKIMA HEART CENTER AT MEMORIAL TRUST 406 S 30TH AVENUE SUITE 101 YAKIMA WA 98902 457017902 MEDICAL SERVICES WA 244839 11925 YVMHA GARDEN VILLAGE 206 S 10TH AVENUE YAKIMA WA 98902 912090034 SKILLED NURSING WA 501(C)(3) LINE 10 N/A 0 CHILDREN'S VILLAGE 3801 KERN ROAD YAKIMA WA 98902 352654720 SUPPORTING ORGANIZATION WA 501(C)(3) LINE 12A, I N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0