2022-11-02T10:09:39-05:00 2021-12-31 861065772 DELOITTE TAX LLP 695 TOWN CENTER DRIVE SUITE 1000 COSTA MESA CA 92626 990 2021-01-01 264146730 GARY AND MARY WEST HEALTH INSTITUTE GARY 8585357000 10350 NORTH TORREY PINES ROAD LA JOLLA CA 92037 SHELLEY LYFORD CEO 8585357000 2022-10-18 1 SHELLEY LYFORD 999009999 DIANA MCCUTCHEN P00545657 7144367100 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z SHELLEY LYFORD 10350 NORTH TORREY PINES ROAD LA JOLLA CA 92037 21045299 0 X WWW.WESTHEALTH.ORG X 2009 DE CONDUCTING MEDICAL RESEARCH WITH HOSPITALS TO REDUCE HEALTHCARE COSTS WITH A FOCUS ON SENIORS. 3 3 29 4 0 0 22500000 21000963 0 0 2 1 0 44335 22500002 21045299 51820 8621 0 0 4690470 4958334 0 0 0 18720671 15181484 23462961 20148439 -962959 896860 9921581 20819217 6012041 16012817 3909540 4806400 X CONDUCTING APPLIED MEDICAL AND SCIENTIFIC RESEARCH INTO ACTIONS TO LOWER HEALTHCARE COSTS AND IMPROVE HEALTHCARE DELIVERY AND SUCCESSFUL AGING FOR SENIOR AMERICAN CITIZENS AND LEGAL RESIDENTS. FURTHERMORE, TO LOWER THE COST OF HEALTHCARE AND ENABLE SENIORS TO SUCCESSFULLY AGE, LIVING LIFE ON THEIR OWN TERMS WITH ACCESS TO HIGH-QUALITY HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE. 0 0 14244446 8621 OVER THE COURSE OF 2021, THE GARY AND MARY WEST INSTITUTE (REFERRED TO BELOW VARIOUSLY AS WHI, WEST HEALTH INSTITUTE OR INSTITUTE) CONTINUED TO ACTIVELY CONDUCT APPLIED MEDICAL RESEARCH, IN CONJUNCTION WITH THE HOSPITALS LISTED ON SCHEDULE A, WITH THE OBJECTIVE OF CONTRIBUTING TO THE BODY OF CLINICAL, SCIENTIFIC, AND HEALTH KNOWLEDGE THAT CAN ULTIMATELY BENEFIT OLDER ADULTS IN AMERICA. OUR RESEARCH METHODOLOGIES ENCOMPASS A VARIETY OF REAL-WORLD DATA COLLECTION AND ANALYSIS TECHNIQUES, AND IN MANY CASES, WE PUT IN PLACE PROGRAMS AND STRUCTURES (E.G., STANDARDIZED CARE MODELS, DATA DASHBOARDS, ETC.) THAT ALLOW US TO COLLECT SYSTEMATIZED RESEARCH INFORMATION WHERE LITTLE PREVIOUSLY EXISTED. THESE MEDICAL RESEARCH EFFORTS DIRECTLY SUPPORTED WHI'S MISSION OF LOWERING THE COST OF HEALTHCARE AND ENABLING SENIORS TO SUCCESSFULLY AGE IN PLACE WITH ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE. OUR MAJOR WORKSTREAMS FOR 2021 BROADLY FIT INTO THE AREAS OF (SENIOR APPROPRIATE) ACUTE AND CHRONIC CARE RESEARCH AND ARE DESCRIBED BELOW.SENIOR-APPROPRIATE ACUTE CARE RESEARCH IN 2021, THE INSTITUTE CONTINUED TO EXPAND ITS RESEARCH PORTFOLIO AND GROW THE BODY OF EVIDENCE FOR NEW STRATEGIES IN ACUTE CARE. UNPLANNED (ACUTE) HEALTH NEEDS REMAIN THE PRIMARY DRIVER OF COST FOR THE NATION'S VULNERABLE OLDER ADULTS, AS WELL AS LEADING TO LASTING DETRIMENTAL EFFECTS (E.G., POST HOSPITAL DEBILITATION AND FUNCTIONAL DECLINE). SUCCESS IN THIS AREA IS ESSENTIAL TO ACHIEVING BETTER, MORE AFFORDABLE OUTCOMES FOR OLDER ADULTS. RESEARCH PROJECT: GERIATRIC EMERGENCY DEPARTMENTS (GEDS)SYSTEMATIZING DATA AND INTERVENTIONS (ACCREDITATION)WHEN OLDER ADULTS ENCOUNTER HEALTH AND/OR SOCIAL CHALLENGES, THE EMERGENCY DEPARTMENT AT A LOCAL HOSPITAL IS MOST OFTEN THE FIRST PLACE WHERE THEY PRESENT. AS SUCH CREATING A SYSTEM OF EMERGENCY DEPARTMENTS THAT ARE 1) EQUIPPED TO RECOGNIZE AND COLLECT INFORMATION ABOUT OLDER ADULTS' HEALTH STATUS AS WELL AS TO 2) DEPLOY A STANDARDIZED SET OF INTERVENTIONS AND GENERATE DATA ABOUT THE EFFECTIVENESS OF THESE INTERVENTIONS, IS AN IMPORTANT RESEARCH PLATFORM FOR IMPROVING OUTCOMES FOR SENIORS. WHI IS USING THE GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION PROGRAM AS A VEHICLE TO ACHIEVE THESE RESEARCH AIMS. THE WHI-SUPPORTED GEDA PROGRAM AWARDED 100 SITE ACCREDITATIONS IN 2021. AS OF DECEMBER 2021, THE PROGRAM INCLUDED OVER 280 TOTAL HOSPITAL EMERGENCY DEPARTMENT (ED) SITES SPREAD ACROSS THE UNITED STATES REPRESENTING OVER 210 CITIES AND TOWNS ACROSS 41 STATES. COUNTRY-WIDE INTEREST IN THE GEDA PROGRAM HAS RESULTED IN A HIGH NUMBER OF APPLICATIONS WITH OVER 70 APPLICATIONS CURRENTLY IN THE PIPELINE AND INTEREST EXPRESSED BY AN ADDITIONAL 182 SITES, PRIORITIES FOR GEDA IN 2022 INCLUDE EXPANDING THE REVIEW BOARD AS WELL AS STREAMLINING THE APPLICATION PROCESS.CALIFORNIA HAS CREATED A STATE MASTER PLAN FOR AGING, AND IS ACTIVELY SEEKING DATA, INCLUDING AND ESPECIALLY FROM EMERGENCY DEPARTMENTS. IN ADDITION TO EFFORTS AT THE NATIONAL LEVEL, WHI HAS ADDITIONALLY PUSHED FORWARD THE CREATION OF A GED RESEARCH NETWORK IN CALIFORNIA LED BY THE STATE ACADEMIC HEALTH RESEARCH INSTITUTIONS, AND IS PURSUING A "HUB-AND-SPOKE" MODEL, WHICH INVOLVES ESTABLISHING A HUB SITE AT THE MAJOR MEDICAL RESEARCH CENTERS WITHIN EACH UC HEALTH SYSTEM ED AS A LEVEL 1 (TOP LEVEL) ACCREDITED GED. ALL FIVE UC FLAGSHIP HOSPITALS, UC SAN DIEGO, UC SAN FRANCISCO, UC DAVIS, UC LOS ANGELES, AND UC IRVINE ARE NOW LEVEL 1 ACCREDITED (OR HAVE APPLIED). STUDYING AND SHARING/PUBLISHING WHAT WORKS (THE GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE)AS PART OF OUR EFFORTS TO CONTINUE TO LEARN AND ASSESS WHAT CONSTITUTES BEST PRACTICES IN GERIATRIC EMERGENCY MEDICINE (I.E., WHICH INTERVENTIONS ARE EFFECTIVE), WHI HAS CO-CREATED AND SUPPORTS THE GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE (GEDC), WHICH IS COMPRISED OF A CORE GROUP OF GERIATRIC EMERGENCY MEDICINE KNOWLEDGE LEADERS AND RESEARCHERS AS WELL AS MEMBER HOSPITAL SITES THAT HAVE GEDS. BY CONVENING EXPERT GED CLINICIANS FROM MEMBER EDS/HEALTH SYSTEMS, AND WITH SUPPORT FROM THE INSTITUTE AND OTHER STAKEHOLDERS, GEDC MEMBERS' RESEARCH CONTINUED TO PROVIDE EVIDENCE THAT GED GUIDELINE-BASED CARE IMPROVES PATIENT OUTCOMES AND IS COST EFFECTIVE. RESEARCH CONDUCTED BY THE GEDC RANGES FROM CASE-STUDIES TO TRADITIONAL CONTROLLED TRIALS FOR PUBLICATION IN PEER-REVIEWED SCIENTIFIC JOURNALS. SEVERAL HIGH-PROFILE PUBLICATIONS BY GEDC FACULTY AND OTHER COLLABORATORS HAVE DEMONSTRATED THE VALUE OF GEDS TO PATIENTS, HOSPITALS, AND PAYORS. THE GEDC ALSO AIDS IN DISSEMINATION OF RESEARCH FINDINGS BEYOND A PUBLICATION MECHANISM. IN DIRECT RESPONSE TO THE GLOBAL PANDEMIC, IN 2021 THE GEDC CONTINUED TO RELEASE COVID-SPECIFIC EDUCATIONAL MATERIALS IN THE FORM OF WEBINARS, PODCASTS, AND BLOG POSTS. THE GEDC ALSO CONTINUED TAILORING THEIR EDUCATIONAL AND TRAINING OFFERINGS TO A WEB-BASED PLATFORM TO ACCOMMODATE VIRTUAL AUDIENCES; CONVENED SUBJECT MATTER EXPERTS FOR MONTHLY WEBINARS; PUBLISHED AND DISSEMINATED BEST PRACTICES (E.G., BLOGS, WHITEPAPERS, ARTICLES); DEVELOPED A COVID-19 TOOLKIT; AND ESTABLISHED AN ONLINE RESOURCE LIBRARY. THE GEDC AND WHI BUILT MOMENTUM TO LEVERAGE INSIGHTS FROM ACTIVE ACCREDITED HEALTH SYSTEMS THROUGH THE HEALTHCARE SYSTEMS ROUNDTABLE AS A VEHICLE FOR SHARING REAL-WORLD RESEARCH FINDINGS ON GERIATRIC EMERGENCY CARE METHODS AND DEPLOYMENTS (SHARING BOTH SUCCESSES AND LESS-THAN-SUCCESSFUL RESULTS). IN 2021, THE HEALTHCARE SYSTEMS ROUNDTABLE TOPICS INCLUDED DELIRIUM SCREENINGS AND COVID-19 CARE IN THE GED. GERIATRIC EMERGENCY MEDICINE RESEARCH AT LARGE SCALE (VETERANS HEALTH ADMINISTRATION (VHA) GERIATRIC EMERGENCY RESEARCH NETWORK)THE VETERANS HEALTH ADMINISTRATION HOSPITAL SYSTEM REPRESENTS PERHAPS THE SINGLE GREATEST HOSPITAL/MEDICAL RESEARCH VENUE IN THE NATION. WITH A SYSTEM OF OVER 170 MEDICAL CENTERS ALL SHARING THE SAME ELECTRONIC HEALTH RECORD SYSTEM AND LARGELY SERVING AN OLDER POPULATION, THE VA IS AN IDEAL SYSTEM IN WHICH TO ADVANCE RESEARCH ON GERIATRIC EMERGENCY DEPARTMENTS, INCLUDING BOTH PROCESS AND OUTCOME MEASURES. TO THIS END, IN 2021, THE INSTITUTE PARTNERED WITH THE VHA AND OTHERS INCLUDING THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, THE GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE AND THE JOHN A. HARTFORD FOUNDATION TO IMPLEMENT AND SCALE GEDS THROUGHOUT THE ENTIRE VHA SYSTEM, ACHIEVING 100% ENGAGEMENT OF VETERANS INTEGRATED SERVICE NETWORK (VISN) REGIONS. AS OF DECEMBER 2021, OVER 50 VHA EDS ARE ENGAGED IN GED PROGRAMMING WITH 16 OF 110 VHA EDS HAVING RECEIVED ACCREDITATION (14.6%) AND AN ADDITIONAL 24 APPLICATIONS IN THE ACCREDITATION WORKFLOW. SYSTEMATIC EVALUATION AND RESEARCH GERIATRIC EMERGENCY MEDICINE HAS BEEN ENABLED THROUGH THE CREATION AND ROLLOUT OF A NOVEL NATIONAL GERIATRIC ED DASHBOARD, A STANDARDIZED DATA COLLECTION MECHANISM AT ALL GED SITES. RESEARCHING NEW STANDARDIZED INTERVENTIONS FOR GEDS: (DELIRIUM RESOURCES FOR THE EMERGENCY DEPARTMENT)FAILURE TO RECOGNIZE AND APPROPRIATELY MANAGE PATIENTS TYPICALLY OLDER ADULTS WITH DELIRIUM IS ASSOCIATED WITH A 3-FOLD INCREASED RISK OF DEATH COMPARED TO THOSE WITHOUT DELIRIUM. THUS, THE ABILITY TO IDENTIFY AND TREAT DELIRIUM IN THE ED IS OF CRITICAL IMPORTANCE AS IT IS OFTEN MISSED IN THE EMERGENCY SETTING. TO SUPPORT EDS, AND GEDS IN PARTICULAR, IN ADDRESSING DELIRIUM, WHI COLLABORATED WITH THE MARCUS INSTITUTE FOR AGING RESEARCH TO SUPPORT RESEARCH DESIGNED TO HELP DEVELOP A CHANGE PACKAGE AND TOOLKIT SPECIFICALLY FOR THE ED- THE END PRODUCT OF WHICH WAS FINALIZED IN APRIL 2021. THE TOOLKIT CONTAINS A VARIETY OF CHANGE MANAGEMENT TOOLS, EDUCATIONAL RESOURCES, AND TEMPLATES TO ASSIST EDS WITH LAUNCHING DELIRIUM INITIATIVES. AS A FOLLOW-ON TO THIS WORK, THE INSTITUTE DEVELOPED A MANUSCRIPT BASED ON A FEASIBILITY PILOT WITH THREE EDS THAT IMPLEMENTED A DELIRIUM PROGRAM USING THE CHANGE PACKAGE AND TOOLKIT ST. MARY MERCY (LIVONIA, MICHIGAN), MAINE MEDICAL CENTER, AND UNIVERSITY OF NORTH CAROLINA HILLSBOROUGH (COMMUNITY HOSPITAL UNDER THE UNC HEALTH CARE SYSTEM). RESEARCH PROJECT: VALUE-BASED CARE HOME-BASED ACUTE CARE LEARNING AND ACTION NETWORK (VBC HOMELAN) IN ADDITION TO RESEARCHING NEEDS AND INTERVENTIONS IN THE EMERGENCY SETTING, AN IMPORTANT AREA OF INVESTIGATION IS UNDERSTANDING OPPORTUNITIES AND METHODS TO DELIVER CARE IN-PLACE WHERE SENIORS LIVE (AND TO DO SO IN A COST-EFFECTIVE, SUSTAINABLE MANNER). THROUGHOUT 2021, THE INSTITUTE ADVANCED ITS VALUE-BASED CARE HOME-BASED ACUTE CARE LEARNING AND ACTION NETWORK (VBC HOMELAN) COLLABORATIVE. THIS COLLABORATIVE IS A "HANDS ON" RESEARCH INITIATIVE THAT SUPPORTS THE ADVANCEMENT AND FINANCIAL SUSTAINABILITY OF HOME-BASED CARE PROGRAMS (MOST LED BY HOSPITALS) CENTERED ON PROACTIVE PATIENT ENGAGEMENT AND AGILE RESPONSES TO UNPLANNED ACUTE EVENTS. 221757 COST OF HEALTHCAREOLDER ADULTS IN AMERICA (AND INDEED ALL INDIVIDUALS RESIDING IN THIS NATION) CONTINUE TO FEEL THE ECONOMIC BURDEN OF WHAT ARE AMONG THE HIGHEST HEALTHCARE COSTS IN THE WORLD. HIGH HEALTHCARE COSTS THREATEN FINANCIAL SECURITY, CURB PATIENT ACCESS, AND CROWD OUT SPENDING IN OTHER IMPORTANT ECONOMIC SECTORS SUCH AS EDUCATION AND SOCIAL SERVICES. THE GARY AND MARY WEST HEALTH INSTITUTE (WHI) REMAINS COMMITTED TO PLAYING AN IMPORTANT ROLE IN CONDUCTING APPLIED MEDICAL RESEARCH TO HELP PROVIDE UNBIASED AND RELIABLE DATA AND FINDINGS THAT ENABLE STAKEHOLDERS IN THE US HEALTH SYSTEM CHART A COURSE TO HEALTHCARE THAT IS MORE AFFORDABLE AND ULTIMATELY A BETTER VALUE FOR OLDER ADULTS IN AMERICA.THE WEST HEALTH INSTITUTE'S AREAS OF FOCUS IN ADDRESSING THE COST OF HEALTHCARE OVER THE PAST YEAR HAVE BEEN CENTERED AROUND CONDUCTING RESEARCH AND SHARING STATISTICS THAT CAN BE USED IN RAISING AWARENESS ABOUT THE SIZE AND URGENCY OF THIS ISSUE, LOWERING PRESCRIPTION DRUG PRICES, AND INCREASING PRICE TRANSPARENCY WITH A GOAL OF HIGHLIGHTING, AND EVENTUALLY REDUCING, OUT-OF-CONTROL HEALTHCARE SERVICE PRICING.GENERATE DATA THAT HIGHLIGHTS TO THE NATURE AND MAGNITUDE OF THE HEALTH SPENDING CRISIS TO FOCUS THE ATTENTION OF POLICYMAKERS, ADMINISTRATORS, AND THE GENERAL PUBLIC ON THE HEALTHCARE CRISIS, WHI UNDERTOOK A VARIETY OF STRUCTURED RESEARCH THAT WAS MADE WIDELY AVAILABLE IN 2021. OVER THE COURSE OF THE YEAR, WHI RELEASED FIVE HIGHLY SUCCESSFUL NATIONAL POLLS IN PARTNERSHIP WITH GALLUP. KEY FINDINGS PICKED UP BY MEDIA INCLUDED: MOST AMERICANS RANK REDUCING THE COST OF CARE AS A HIGH PRIORITY; AN ESTIMATED 46 MILLION CANNOT AFFORD NEEDED CARE TODAY; AND ONE IN SIX WORKERS ARE STAYING IN UNWANTED JOBS FOR HEALTH BENEFITS. THE GALLUP WORK ALSO INCLUDED THREE NATIONAL WEBINARS WITH WHICH SHARED OUR POLLING RESULTS. FINALLY, WE CLOSED THE YEAR BY PUBLISHING A LANDMARK 2021 "HEALTHCARE IN AMERICA REPORT," WHICH SHARED DATA THAT CHARACTERIZED THE GREAT INCREASE IN BURDEN OF HEALTHCARE COSTS AND THE GROWING WORRY ABOUT HEALTHCARE COSTS AMID COVID-19. THE REPORT WAS COVERED BY OVER 150 MEDIA OUTLETS.ADVANCE RESEARCH HELPING TO UNDERSTAND HOW DRUG COSTS MAY BE LOWERED; LEVERAGE DATA SCIENCE TO ILLUSTRATE PRICING DISPARITIES IN HEALTH SERVICESWHI WAS ABLE TO USE ITS DATA SCIENCE RESEARCH TEAM TO ANALYZE LARGE DATA SETS IN SUPPORT OF HYPOTHESES AROUND PRICE ISSUES IN BOTH DRUGS AND HEALTH SERVICES. FOR EXAMPLE, WHI DATA SCIENCE SUPPORT AND GUIDANCE WERE KEY TO A PUBLICATION IN JAMA OPEN, ESTIMATING SAVINGS FORM REFORMING MEDICARE REIMBURSEMENT POLICIES FOR BIOSIMILAR PRODUCTS, (GENERATING A HIGHLY FAVORABLE EDITORIAL COMMENT PUBLISHED ALONGSIDE THE ARTICLE). ADDITIONALLY, IN 2021, WHI ANALYZED LARGE AMOUNTS OF COMMERCIAL INSURER DATA VIA AN AGREEMENT WITH THE HEALTHCARE COST INSTITUTE (HCCI) TO SHOW THE INCONSISTENT AND EXTREMELY HIGH PRICES THAT MANY PROVIDERS CHARGE, HIGHLIGHTING THAT MARKET FAILURES MAY EXIST IN THE U.S. HEALTHCARE SYSTEM. RESEARCH AND DATA SUPPORT FOR THE CALIFORNIA MASTER PLAN FOR AGINGTHE MASTER PLAN FOR AGING (MPA) IN CALIFORNIA IS A BLUEPRINT FOR STATE AND LOCAL GOVERNMENT, THE PRIVATE SECTOR, AND PHILANTHROPY TO PREPARE THE STATE FOR THE PROJECTED DEMOGRAPHIC CHANGES AND AMPLIFY CALIFORNIA'S LEADERSHIP IN AGING, DISABILITY, AND EQUITY. THE URGENCY TO COMPLETE AND BEGIN IMPLEMENTATION OF THE MASTER PLAN WAS MAGNIFIED BY THE ONSET OF COVID-19, WHICH EXPOSED PERSISTENT AND SYSTEMIC INEQUITIES THAT DISPROPORTIONATELY IMPACTED OLDER CALIFORNIANS, PEOPLE WITH DISABILITIES AND COMMUNITIES OF COLOR. OVER THE COURSE OF 2021, WHI HAD THE OPPORTUNITY TO CONTINUE TO PROVIDE SCIENCE-DRIVEN INPUT INTO THE MPA IN A NUMBER OF WAYS. FINDINGS FROM THE GERIATRIC EMERGENCY DEPARTMENT (GED) RESEARCH WORKSTREAM WAS SHARED WITH POLICYMAKERS AND HAS RESULTED IN GEDS BEING SPECIFICALLY CALLED OUT IN THE MPA AS A MECHANISM FOR ONGOING DATA COLLECTION, AMONG OTHER FUNCTIONS. ADDITIONALLY, THE INSTITUTE HAS TAKEN A LEADING ROLE IN THE DEVELOPMENT OF THE DATA DASHBOARD FOR AGING, WHICH TRACKS THE MASTER PLAN'S TARGETS CURRENTLY AND OVER TEN YEARS. THE DATA DASHBOARD WAS CO-DEVELOPED BY THE CALIFORNIA DEPARTMENTS OF AGING AND PUBLIC HEALTH AND THE WEST HEALTH INSTITUTE AND SHOWCASES HOW RESEARCH AND DATA CAN BE USED TO BOTH INFORM AND EVALUATE POLICY DECISIONS AT A MACRO LEVEL. 14466203 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 30 0 1 29 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 CA DE X SALLY HALLAK 8585357000 10350 N TORREY PINES ROAD LA JOLLA CA 92037 X CHARLES SEDERSTROM DIRECTOR 5.00 1.00 X 0 0 0 GARY WEST DIRECTOR, CHAIRMAN 15.00 12.00 X 0 0 0 MARK MCCLELLAN DIRECTOR 10.00 5.00 X 0 0 0 NICK VALERIANI DIRECTOR 15.00 5.00 X 0 0 0 SHELLEY M LYFORD PRESIDENT & CEO 30.00 35.00 X 747512 281544 37621 TIMOTHY LASH EVP & CHIEF STRATEGY OFFICER 30.00 35.00 X 637435 178317 60127 ZIA AGHA CHIEF MEDICAL OFFICER & EVP CLINICAL RESEARCH 40.00 8.00 X 698101 48081 63142 JONATHAN ZIFFERBLATT EVP, STRATEGY & SUCCESSFUL AGING 50.00 0.00 X 0 431711 48605 SALLY HALLAK SECRETARY AND TREASURER 30.00 25.00 X 0 352734 28772 SIOBHAN GRAHAM VP, OPERATIONS & HR (TERMED 9/24/21) 50.00 0.00 X 0 218642 20237 JOSE UNPINGCO SENIOR DIRECTOR OF DATA SCIENCE 40.00 X 261486 0 52247 AMY STUCK SR. 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MANAGEMENT EVALUATED ITS TAX POSITIONS AND DETERMINED THAT IT HAS NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2021. THERE HAVE BEEN NO RELATED TAX PENALTIES OR INTEREST, WHICH WOULD BE CLASSIFIED AS TAX EXPENSE IN THE STATEMENT OF ACTIVITIES. SCHEDULE D, PART IX LINE 1 AND PART X LINE 2 THE INSTITUTE LEASES ITS LA JOLLA FACILITY UNDER AN OPERATING LEASE AGREEMENT THAT EXPIRES IN APRIL 2028. WHI ADOPTED THE NEW LEASE STANDARD ASC 842 AT THE BEGINNING OF 2021. IN ACCORDANCE WITH ASC 842, THE INSTITUTE RECOGNIZES A RIGHT-OF-USE ASSET AND LEASE LIABILITY IN THE BALANCE SHEET RELATED TO THE OPERATING LEASE. THIS RESULTS IN AN INCREASE IN TOTAL ASSETS AND TOTAL LIABILITIES ON THE BALANCE SHEETS. 1 GARY AND MARY WEST SENIOR DENTAL CENTER INC 1525 FOURTH AVE SAN DIEGO CA 92101 473001738 501(C)(3) 0 7658 FMV OFFICE SPACE DONATION OF OFFICE SPACE 2 PART I, LINE 2: GRANTS WILL ONLY BE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE NON-CASH ITEMS WILL BE USED PROPERLY. X 1 1 X X X X 0 1 0 0 0 0 0 1 0 SHELLEY M LYFORD PRESIDENT & CEO 575274 249770 151673 31774 20565 0 11400 7843 7268 11110 766180 300497 0 0 TIMOTHY LASH EVP & CHIEF STRATEGY OFFICER 493916 159211 123519 19106 20000 0 7208 11532 40171 1216 684814 191065 0 0 ZIA AGHA CHIEF MEDICAL OFFICER & EVP CLINICAL 551235 48081 126504 0 20362 0 14500 0 48642 0 761243 48081 0 0 JONATHAN ZIFFERBLATT EVP, STRATEGY & SUCCESSFUL AGING 0 326375 0 85063 0 20273 0 14500 0 34105 0 480316 0 0 SALLY HALLAK SECRETARY AND TREASURER 0 269878 0 63078 0 19778 0 14500 0 14272 0 381506 0 0 JOSE UNPINGCO SENIOR DIRECTOR OF DATA SCIENCE 233031 0 27930 0 525 0 13394 0 38853 0 313733 0 0 0 AMY STUCK SR. DIR, VALUE-BASED ACUTE CARE 177946 0 26800 0 691 0 10552 0 44157 0 260146 0 0 0 CHRIS CROWLEY PROGRAM MANAGER 208954 0 18710 0 1267 0 11445 0 18854 0 259230 0 0 0 LIANE WARDLOW DIRECTOR, CLINICAL RESEARCH 170250 0 17931 0 227 0 9702 0 43476 0 241586 0 0 0 SIOBHAN GRAHAM VP, OPERATIONS & HR (TERMED 9/24/21) 0 154041 0 40024 0 24577 0 8979 0 11258 0 238879 0 0 ADRIAN KWONG PRINCIPAL DATA SECURITY ARCHITECT 189160 0 14925 0 256 0 9608 0 14897 0 228846 0 0 0 PART I, LINE 1A THE USE OF BUSINESS CLASS MAY BE AUTHORIZED UNDER THE CIRCUMSTANCES LISTED BELOW: (1) INTERNATIONAL TRAVEL; (2) BUSINESS OR FIRST CLASS IS THE ONLY SERVICE OFFERED BETWEEN TWO POINTS; (3) COACH CLASS WOULD BE MORE EXPENSIVE OR TIME CONSUMING, E.G., WHEN, BECAUSE OF SCHEDULING DIFFICULTIES, TRAVELING BY COACH WOULD REQUIRE AN UNNECESSARY HOTEL EXPENSE, CIRCUITOUS ROUTING (2 OR MORE LAYOVERS), OR AN UNDULY LONG LAYOVER WHEN MAKING CONNECTIONS; (4) AN ITINERARY INVOLVES OVERNIGHT TRAVEL WITHOUT THE OPPORTUNITY FOR NORMAL REST BEFORE THE COMMENCEMENT OF WORKING HOURS; OR (5) THE USE OF BUSINESS CLASS IS NECESSARY TO REASONABLY ACCOMMODATE A DISABILITY OR MEDICAL NEED OF A TRAVELER. PART I, LINE 3 COMPENSATION FOR THE CEO WAS ESTABLISHED BY THE BOARD OF DIRECTORS OF THE GARY AND MARY WEST HEALTH INSTITUTE AND PAID BY THE INSTITUTE. THE FOLLOWING WAS USED TO ESTABLISH THE COMPENSATION: 1)COMPENSATION COMMITTEE; 2)FORM 990 OF OTHER ORGANIZATIONS; 3)COMPENSATION SURVEY OR STUDY; 4)APPROVAL BY THE BOARD OF DIRECTORS. PART I, LINE 4B 17B: EACH OF THE FOLLOWING INDIVIDUALS TIMOTHY LASH, ZIA AGHA AND SHELLEY M. LYFORD (LISTED ON SCHEDULE J) PARTICIPATED IN THE 457(B) NONQUALIFIED DEFINED CONTRIBUTION PLAN OFFERED BY THE WEST HEALTH INSTITUTE. THE GARY AND MARY WEST HEALTH INSTITUTE MAKES AN ANNUAL CASH CONTRIBUTION FOR EACH EMPLOYEE IN AN AMOUNT EQUAL TO THE APPLICABLE DOLLAR AMOUNT IN EFFECT FOR THAT YEAR. FOR 2021 THIS AMOUNT WAS $19,500. CONTRIBUTIONS WERE MADE FOR TIMOTHY LASH, ZIA AGHA AND SHELLEY LYFORD. JONATHAN ZIFFERBLATT AND SALLY HALLAK (ALSO LISTED ON SCHEDULE J) PARTICIPATED IN THE 409A NONQUALIFIED DEFINED CONTRIBUTION PLAN OFFERED BY THE GARY AND MARY WEST MANAGEMENT COMPANY, INC., A RELATED ORGANIZATION. FOR 2021 THIS AMOUNT WAS $19,500. CONTRIBUTIONS WERE MADE FOR JONATHAN ZIFFERBLATT AND SALLY HALLAK. PART I, LINE 7 EACH OF THE MANAGERS IS ELIGIBLE FOR AN ANNUAL DISCRETIONARY BONUS, SUBJECT TO BOARD APPROVAL, WHICH IS BASED ON INDIVIDUAL PERFORMANCE AND LIMITED TO A MAXIMUM PERCENTAGE OF BASE COMPENSATION. SEE PART V DISCLOSURE 0 SCHEDULE L, PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: GARY WEST, CHAIRMAN OF THE WEST HEALTH INSTITUTE, IS A MEMBER OF 99 TEN BUSINESS SOLUTIONS, LLC. GARY WEST IS TREATED AS AN INTERESTED PERSON FOR PURPOSES OF SCHEDULE L, PART IV. ADDRESSING BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. THERE WERE BUSINESS TRANSACTIONS BETWEEN THE INSTITUTE AND 99 TEN BUSINESS SOLUTIONS, LLC DURING 2021. TOTAL TRANSACTION AMOUNT IS $315,816 FOR IT CONSULTING SERVICES. THE COMPENSATION PAID WAS LESS THAN THE COMMERCIAL MARKET CHARGES FOR SUCH SERVICES. SCHEDULE L PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: WEST HEALTH INSTITUTE ("WHI") SHARES COMMON OFFICERS. TIMOTHY LASH, ZIA AGHA AND JONATHAN ZIFFERBLATT. IN 2021, GARY AND MARY WEST SENIOR SERVICES AND WHI ENTERED INTO A JOINT RESEARCH COLLABORATION AGREEMENT VALUED AT $2,000,000. FORM 990, PART I, LINE 20 THE INSTITUTE LEASES ITS LA JOLLA FACILITY UNDER AN OPERATING LEASE AGREEMENT THAT EXPIRES IN APRIL 2028. WHI ADOPTED THE NEW LEASE STANDARD ASC 842 AT THE BEGINNING OF 2021. IN ACCORDANCE WITH ASC 842, THE INSTITUTE RECOGNIZES A RIGHT-OF-USE ASSET AND LEASE LIABILITY IN THE BALANCE SHEET RELATED TO THE OPERATING LEASE. THIS RESULTS IN AN INCREASE IN TOTAL ASSETS AND TOTAL LIABILITIES ON THE BALANCE SHEETS. FORM 990, PART III, LINE 4A, (CONTINUATION): THE SPECIFIC AIMS FOR THE 2021 VBC HOMELAN WERE TO DEPLOY AND MEASURE METHODS DESIGNED TO REDUCE HOSPITALIZATIONS AND ED VISITS, ENABLING SENIORS TO REMAIN IN THEIR HOMES AND COMMUNITIES, AND PROGRESS FINANCIAL SUSTAINABILITY OF THE ACUTE CARE AT HOME PROGRAMS. FOR THE 2021 ROSTER WE CHOSE SIX EXCEPTIONAL RISK-BASED COLLABORATORS, INCLUDING HOSPITAL-BASED PARTNERS UNITYPOINT HEALTH (IOWA), INTEGRA (RHODE ISLAND), HEALTHPARTNERS (MINNESOTA), AND MOUNT SINAI (NEW YORK), AS WELL AS COMMUNITY-BASED PARTNERS INTEGRATED HEALTHCARE ALLIANCE (CALIFORNIA) AND VISITING NURSE ASSOCIATION HEALTH GROUP (NEW JERSEY). THE STRATEGY WAS TO FOCUS ON TEAMS THAT CONTINUED TO EMBRACE MORE FINANCIAL RISK AND EXHIBITED A TRACK RECORD OF RESEARCHING AND DEPLOYING CARE IMPROVEMENT IN ITERATIVE ROUNDS OF IMPROVEMENT. THE OVERALL 2021 VBC HOMELAN RESULTS EXCEEDED OUR EXPECTATIONS. A DASHBOARD WAS DEPLOYED TO METHODICALLY COLLECT AND STANDARDIZE DATA GENERATED BY THESE MODELS. THE INSTITUTE COLLECTED THE TOP-LEVEL RESULTS OF AVERTED VISITS AND GROSS COSTS AND DEVELOPED THE ABILITY TO TRACK AND ANALYZE THE NET FINANCIAL IMPACT TO BOTH MEDICARE AND THE PROVIDERS. FOR THE SIX ORGANIZATIONS OVER 10 MONTHS, DATA INDICATED THAT OVER 906 EMERGENCY ROOM VISITS AND OVER 529 INPATIENT HOSPITAL ADMISSIONS WERE AVOIDED, FOR A COLLECTIVE TOP-LINE (GROSS) SAVINGS TO MEDICARE OF OVER $8.4M. THE INSTITUTE'S FOCUS ON MEASURING NET SAVINGS FURTHER EXTENDED THE RESILIENCY OF OUR COLLABORATORS AND THEIR ABILITY TO SCALE THE PROGRAMS IN TERMS OF FOSTERING SUSTAINABLE DELIVERY OF COST-LOWERING PROGRAMS. SENIOR-APPROPRIATE CHRONIC CARE RESEARCH SYSTEMATICALLY ADDRESSING THE ONGOING COMPLEX MEDICAL, BEHAVIORAL, AND SOCIAL NEEDS OF OLDER ADULTS IN A COST-EFFECTIVE MANNER WHILE ENSURING THAT WHAT MATTERS MOST TO THEM IS TAKEN INTO ACCOUNT IS AN IMPORTANT PART OF THE INSTITUTE'S RESEARCH. THESE ACTIVITIES COVER A VARIETY OF AREAS. RESEARCH PROJECT: LEARNING AND DEPLOYING OPTIMIZED CARE IN THE PACE SETTING: THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) IS A FEDERALLY FUNDED AND REGULATED PROGRAM THAT PROVIDES WRAP-AROUND MEDICAL AND SOCIAL SERVICES FOR SENIORS WHO WOULD OTHERWISE NEED NURSING HOME LEVEL CARE. MANAGING THE CHRONIC CONDITIONS AND NEEDS OF THIS HIGH-COST, HIGH-NEED POPULATION SEGMENT REQUIRES COORDINATED CARE TO ENABLE AGING-IN-PLACE AT HOME. THE INSTITUTE IS WORKING TO DEVELOP AND EXECUTE ON AN INNOVATIVE PROGRAM OF APPLIED MEDICAL RESEARCH STUDIES TO BETTER UNDERSTAND AND EXPLORE HOW CARE CAN BE INCREASINGLY DELIVERED WITH HIGH EFFICIENCY (INCLUDING COST EFFICIENCY) AND QUALITY AT PACE. BUILDING SYSTEMS TO GATHER DATA AND TEST HYPOTHESES (POPULATION HEALTH RESEARCH DASHBOARDS) BUILDING ON WEST HEALTH INSTITUTE'S EXISTING WORK TO ADVANCE THE USE OF DATA AND ANALYTICAL TOOLS SUCH AS DECISION-SUPPORT DASHBOARDS, THE INSTITUTE IS ESTABLISHING CLINICAL AND OPERATIONAL DASHBOARDS FOR USE IN PACE PROGRAMS. PACE PROGRAMS HAVE HISTORICALLY HAD A DIFFICULT TIME COLLECTING AND USING DATA TO INFORM DECISION-MAKING, LARGELY DUE TO INFORMATION BEING SILOED IN ONE OF MANY (OFTEN 7-10) DIFFERENT DATABASES. OUR RESEARCH HYPOTHESIS IS THAT BRINGING TOGETHER AND ORGANIZING DATA FROM A VARIETY OF DATABASES INTO ONE SYSTEM WILL ALLOW US TO DELIVER JUST-IN-TIME METRICS IN AN EASY-TO-CONSUME MANNER. FURTHER, BY DOING THIS, WE WILL HELP PACE CLINICAL AND ADMINISTRATIVE STAFF BETTER CHARACTERIZE AREAS OF NEED, DELIVER TARGETED SERVICES MORE EFFICIENTLY AND EFFECTIVELY TO THE MOST AT-RISK PACE PARTICIPANTS, AND ASSESS THE UTILITY OF THESE INTERVENTIONS. IN 2021, TWO DASHBOARDS WERE COMPLETED AND MADE AVAILABLE. THESE DASHBOARDS WERE PRIORITIZED BECAUSE THEY ARE TWO OF THE MOST CLINICALLY IMPORTANT AND FINANCIALLY RELEVANT AREAS FOR PACE: 1) UTILIZATION AND COSTS RELATED TO EMERGENCY DEPARTMENT VISITS AND HOSPITALIZATION, AND 2) TELEHEALTH COSTS AND UTILIZATION (BOTH PACE-INTERNAL AND WITH OUTSIDE SPECIALISTS). TWO ADDITIONAL DASHBOARDS WERE >80% COMPLETE AS OF 2021 END-OF-YEAR:1) A FINANCIAL DASHBOARD THAT DISPLAYS KEY INCOME AND EXPENSE DATA, AND 2) A TRANSPORTATION DASHBOARD THAT DISPLAYS COST AND UTILIZATION OF SCHEDULED AND UNSCHEDULED TRANSPORTATION (A LARGE COST DRIVER FOR THE PROGRAM, PARTICULARLY DURING THE PUBLIC HEALTH EMERGENCY). AN EVALUATION PLAN WAS ALSO CREATED AND DEPLOYED TO TRACK THE USAGE AND USEFULNESS OF THE DASHBOARDS OVER TIME. TESTING NEW INTERVENTIONS (REDUCING POTENTIALLY AVOIDABLE HOSPITAL AND EMERGENCY DEPARTMENT ADMISSIONS) A PACE CLINIC IS TYPICALLY EQUIPPED WITH SOME DEGREE OF AGILE RESPONSE INFRASTRUCTURE, INCLUDING SAME-DAY APPOINTMENTS, TRANSPORTATION TO AND FROM THE CLINIC, AND A CREW OF SOCIAL WORKERS, PROVIDERS, AND PHYSICAL/OCCUPATIONAL THERAPISTS TO MEET THE NEEDS OF THEIR PARTICIPANTS. HOWEVER, BECAUSE SOME PACE PARTICIPANTS REMAIN CONDITIONED TO CALL 911 IN AN EMERGENCY, IN 2021 THE INSTITUTE EXPLORED OPPORTUNITIES TO INTERCEPT PARTICIPANTS' NON-LIFE-THREATENING MEDICAL CONCERNS USING A MOBILE HEALTH/COMMUNITY PARAMEDICINE SERVICE. SPECIFICALLY, WE CONDUCTED A PILOT STUDY TO INVESTIGATE THE FEASIBILITY OF USING A SUCH A SERVICE TO PROVIDE SCHEDULED AND ON-DEMAND VISITS TO PARTICIPANT'S HOMES. THIS STUDY WAS DESIGNED TO BOTH DETERMINE THE OPTIMAL WORKFLOWS FOR USING MOBILE HEALTH AND THEN PERFORM A PRE/POST ASSESSMENT ON EFFECTIVENESS OF THIS INTERVENTION. THOUGH THERE WERE LOW ACUTE ACTIVATIONS OF THE SERVICE, WE FOUND USING THIS SERVICE WAS FEASIBLE AND OFFERED OPPORTUNITIES TO IDENTIFY CLINICAL PROBLEMS BEFORE THEY BECAME SEVERE ENOUGH TO WARRANT AN ED VISIT. NEARING THE END OF 2021, ED VISITS AND HOSPITALIZATIONS FOR PACE PARTICIPANTS WERE TRENDING DOWNWARD. LIKE ALL OF OUR WORK, THESE RESULTS WILL BE SHARED TO ENABLE INFORMED DECISION MAKING BY OTHER PACE AND COMPLEX-CARE DELIVERY ORGANIZATIONS. RESEARCH PROJECT: HOME-BASED MONITORING HOME-BASED PRIMARY CARE (HBPC) IS A MULTIDISCIPLINARY ONGOING CARE STRATEGY FOR PROVIDING IN-HOME TREATMENT PRIMARILY TO ADDRESS MEDICALLY COMPLEX HOMEBOUND SENIORS' NEEDS. RECENT STUDIES HAVE DEMONSTRATED THAT HBPC CAN BE A COST-EFFECTIVE STRATEGY FOR DELIVERING CARE TO FRAIL PATIENTS WHILE MAINTAINING OR IMPROVING QUALITY OF CARE AND PATIENT SATISFACTION. THIS PAST YEAR (2021) SAW THE CONCLUSION OF WHI'S MULTI-YEAR RESEARCH COLLABORATION WITH NORTHWELL HEALTH'S HOUSE CALLS PROGRAM, THE "HOME-BASED MONITORING TO ENHANCE AND SCALE A HIGH-TOUCH HOME-BASED PRIMARY CARE PROGRAM." THE RESEARCH AIMED TO EXPAND THE PATIENT CENSUS IN THE HOUSE CALLS PRACTICE OF NEW YORK STATE'S LARGEST MULTI-HOSPITAL HEALTH SYSTEM THROUGH REDESIGN OF SCHEDULED IN-HOME VISITS USING A NEW, INNOVATIVE CARE TEAM COMPOSITION AND TELEHEALTH TECHNOLOGY. IN 2021, THE HOUSE CALLS PRACTICE CONTINUED TO SERVE ITS FRAIL, HOMEBOUND SENIORS USING THIS NEW MODEL OF CARE. DISSEMINATION EFFORTS TO SUPPORT THE GROWTH OF THIS MODEL TO OTHER PRACTICES RESULTED IN A PUBLISHED PEER-REVIEWED PAPER "EMERGENCY MEDICAL TECHNICIAN-FACILITATED TELEHEALTH VISITS: A NEW MODEL TO EXPAND HOME-BASED PRIMARY CARE FOR HOMEBOUND SENIORS" IN TELEHEALTH AND MEDICINE TODAY AND AN IMPLEMENTATION GUIDE, "A PRACTICAL GUIDE TO EXPANDING HOME-BASED PRIMARY CARE WITH TELEHEALTH" RESEARCH PROJECT: COMPARISON OF TELEHEALTH AND IN-PERSON CARE TELEHEALTH RESEARCH IS AN IMPORTANT AREA OF FOCUS IN ADVANCING THE HEALTH NEEDS OF SENIORS. IN THE WAKE OF THE PANDEMIC, TELEHEALTH ENCOUNTERS HAVE INCREASED, AND IT IS ESSENTIAL TO BETTER CHARACTERIZE THE ATTRIBUTES OF TELEHEALTH AS IT RELATES TO CARE FOR OLDER ADULTS. THE YEAR 2021 SAW THE CULMINATION OF A MULTI-YEAR, MULTI-COLLABORATOR EFFORT LED BY WHI TO EXAMINE THE EFFICACY OF TELEHEALTH ENCOUNTERS VS. IN-PERSON VISITS IN RESOLVING CARE NEEDS FOR SENIORS. PERFORMED IN CONJUNCTION WITH THREE LARGE HOSPITAL HEALTH SYSTEMS: KAISER, JEFFERSON HEALTH, AND SPECTRUM HEALTH, AND PUBLISHED IN THE JOURNAL OF TELEMEDICINE AND TELECARE AS "URGENT/NON-EMERGENT TELEHEALTH CARE FOR SENIORS: FINDINGS FROM A MULTI-SITE IMPACT STUDY" (APRIL 2021), THE STUDY EXAMINED OVER 300,000 ENCOUNTERS OVER 3 YEARS AND DEMONSTRATED THAT TELEHEALTH WAS SUCCESSFUL IN RESOLVING URGENT AND NON-EMERGENT NEEDS IN ROUGHLY 85% OF CASES. WHEN VISITS REQUIRED FOLLOW-UP, OVER 95% WERE RESOLVED IN LESS THAN THREE VISITS FOR BOTH TELEHEALTH AND IN-PERSON COHORTS. REGARDLESS OF REIMBURSEMENT AND OPERATIONAL MODELS, VISIT TELEHEALTH RESOLUTION RATES WERE SIMILAR TO IN-PERSON CARE. THESE FINDINGS BOTH REINFORCE THAT TELEHEALTH IS AN EFFECTIVE AND VIABLE CARE MODALITY FOR SENIORS TO UTILIZE AS WELL AS THE NEED FOR STRUCTURED MEDICAL RESEARCH TO CREATE RELIABLE DATA WHICH CAN BE USED IN THE EVALUATION OF NEW MODELS OF CARE. FORM 990, PART VI, SECTION A, LINE 2 THE MAJORITY OF THE CURRENT DIRECTORS AND OFFICERS HAVE A "BUSINESS RELATIONSHIP" AS DEFINED IN THE FORM 990 INSTRUCTIONS, WITH EACH OF THE OTHER CURRENT OFFICERS AND DIRECTORS BECAUSE OF POSITIONS THEY HOLD WITH AFFILIATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 3 GARY AND MARY WEST MANAGEMENT COMPANY, INC., ("WMC") IS A NON-PROFIT, TAXABLE ENTITY THAT PROVIDES SERVICES TO AFFILIATED ORGANIZATIONS. CERTAIN SUPERVISORY, FINANCIAL AND OTHER ADMINISTRATIVE FUNCTIONS ARE PREFORMED BY EMPLOYEES OF GARY AND MARY WEST MANAGEMENT COMPANY, INC. SALLY HALLAK, SIOBHAN GRAHAM (THRU 9/24/2021), AND JONATHAN ZIFFERBLATT ARE OFFICERS OF WHI AND RELATED ORGANIZATIONS BUT ARE DIRECT EMPLOYEES OF WMC. (REFER TO SCHEDULE J). TOTAL OFFICER COMPENSATION PAID TO THESE OFFICERS IS $979,632 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NON-PROFIT, NON-STOCK CORPORATION WITH THREE MEMBERS DURING 2021. ONE INCORPORATED MEMBER DESIGNATED AS A PERMANENT MEMBER, THE GARY AND MARY WEST FOUNDATION, AND TWO NON-INCORPORATED MEMBERS WHICH ARE ELECTED AND TERM-BASED MEMBERS, JAMES K HASSON AND THOMAS CULHANE. ADDITIONALLY, MEMBERS APPOINT AND CAN REMOVE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION HAVE THE AUTHORITY TO ELECT AND REMOVE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS REQUIRE MEMBER APPROVAL: 1. THE DISSOLUTION, LIQUIDATION, MERGER, CONSOLIDATION, RECAPITALIZATION OR OTHER REORGANIZATION OF THE CORPORATION; 2. THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION; AND 3. ANY CHANGES PROPOSED TO BE MADE BY THE CORPORATION'S BOARD OF DIRECTORS TO THE CORPORATION'S CERTIFICATE OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 INFORMATION WAS COMPILED FROM THE ORGANIZATION'S CORPORATE AND ACCOUNTING RECORDS AND PROVIDED TO THE ORGANIZATION'S OUTSIDE TAX PREPARER. THE COMPLETED FORM 990 WAS REVIEWED BY THE ORGANIZATION'S CFO, OUTSIDE LEGAL COUNSEL AND CEO. UPON SATISFACTORY COMPLETION OF THE INTERNAL REVIEW PROCESS, A DRAFT OF THE FORM 990 WAS CIRCULATED TO THE ORGANIZATION'S AUDIT COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW. THE FORM 990 WAS THEN FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS AND OFFICERS OF THE INSTITUTE MET REGULARLY THROUGHOUT 2021 AND DISCUSSED ALL ACTUAL AND POTENTIAL CONFLICTS OF INTEREST THAT EXISTED WITH RESPECT TO OTHER NON-PROFIT AND BUSINESS ORGANIZATIONS. THE DIRECTORS AND OFFICERS ALSO COLLECTED ANNUAL WRITTEN CONFLICT OF INTEREST STATEMENTS FROM ALL DIRECTORS AND OFFICERS. NO FAILURES OF COMPLIANCE WITH THE POLICY WERE FOUND. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION APPROVAL PROCESS FOR ITS EMPLOYEES. FOR THOSE PAID IN EXCESS OF $100,000, A BASIC COMPENSATION STUDY IS PERFORMED AND COMPENSATION RANGES ARE REQUIRED TO BE APPROVED BY THE BOARD OF DIRECTORS. FOR THOSE PAID IN EXCESS OF $250,000, SUCH AS THE CEO, AN ENHANCED STUDY OF COMPARABLE COMPENSATION IS PERFORMED AND THE BOARD OF DIRECTORS REVIEWS AND APPROVES COMPENSATION LEVELS. THE ORGANIZATION HAS ALSO RETAINED THE SERVICES OF AN OUTSIDE COMPENSATION CONSULTANT. THE MOST RECENT REVIEW WAS DONE IN 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CERTIFICATE OF INCORPORATION AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON THE REQUEST FOR SUCH DOCUMENTS. FORM 990, PART VII: THE ORGANIZATION HAS A MANAGEMENT SERVICES AGREEMENT WITH THE GARY AND MARY WEST MANAGEMENT COMPANY, INC., A RELATED NON-PROFIT CORPORATION, WHEREBY THE GARY AND MARY WEST MANAGEMENT COMPANY, INC. PROVIDES CERTAIN ADMINISTRATIVE SUPPORT SERVICES TO THE ORGANIZATION. SUCH SERVICES INCLUDE THAT OF VARIOUS SENIOR MANAGEMENT ROLES. THE BELOW OFFICER'S COMPENSATION FROM GARY AND MARY WEST FOUNDATION WERE PRORATED AND REPORTED ON PART VII: SHELLEY LYFORD, TIMOTHY LASH AND ZIA AGHA. THE PERIOD THAT GARY AND MARY WEST FOUNDATION WAS CONSIDERED A RELATED PARTY IS 01/01/2021-12/8/2021. FORM 990, PART IX, LINE 11G OTHER CONSULTANTS: PROGRAM SERVICE EXPENSES 856,108. MANAGEMENT AND GENERAL EXPENSES 1,269,948. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,126,056. RESEARCH STUDIES: PROGRAM SERVICE EXPENSES 7,052,627. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,052,627. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 630. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 630. STAKEHOLDER COMMUNICATIONS: PROGRAM SERVICE EXPENSES 3,500. MANAGEMENT AND GENERAL EXPENSES 26,656. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,156. GARY AND AMRY WEST HEALTH POLICY CENTER 1909 K STREET NW SUITE 730 WASHINGTON DC 20006 275388874 SEE SCH R. PART VII DE 501(C)(3) PF N/A 0 GARY AND MARY WEST HEALTH ENDOWMENT INC 1313 N MARKET ST SUITE 5300 WILLINGTON DE 19801 272953865 FINANCIAL SUPPORT DE 501(C)(3) 11 N/A 0 GARY AND MARY WEST FOUNDATION 10350 N TORREY PINES RD LA JOLLA CA 92037 470793015 SEE SCH R. PART VII DE 501(C)(3) PF N/A 0 GARY AND MARY WEST MANAGEMENT COMPANY INC 5800 ARMADA DRIVE SUITE 100 CARLSBAD CA 92008 454040871 SEE SCH R, PART VII DE N/A C 0 DIGITAL HEALTH CORP 10350 N TORREY PINES ROAD LA JOLLA CA 920371055 820903337 SEE SCH R, PART VII DE GARY AND MARY WEST HEALTH ENDOWMENTINC C 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 PART II: IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST HEALTH POLICY CENTER, INC. PRIMARY ACTIVITY: POLICY RESEARCH TO DEVELOP MORE AFFORDABLE HEALTHCARE MODELS ENABLING SENIORS TO SUCCESSFULLY AGE. PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST MANAGEMENT COMPANY, INC. TYPE OF ENTITY: GARY AND MARY WEST MANAGEMENT COMPANY, INC. IS A NON-STOCK, NON-PROFIT CORPORATION TAXED AS A C-CORPORATION THAT PROVIDES CERTAIN ADMINISTRATIVE SUPPORT SERVICES. PRIMARY ACTIVITY: PROVIDING ADMINISTRATIVE SUPPORT SERVICES. PART II: IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST WEST FOUNDATION PRIMARY ACTIVITY: PROVIDES OUTCOMES-BASED FUNDING TO SUPPORT INITIATIVES THAT LOWER THE COST OF HEALTHCARE TO ENABLE SENIORS TO SUCCESSFULLY AGE. PERIOD THAT GARY AND MARY WEST FOUNDATION WAS CONSIDERED A RELATED PARTY IS 1/1/2021 - 12/8/2021. RENT FACILITY SPACE: 1,473 SQUARE FEET OF OFFICE SPACE AND COMMON AREAS. PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: DIGITAL HEALTH CORP. PRIMARY ACTIVITY: HEALTHCARE COMPANY THAT HARNESSES THE POWER OF THE LATEST TECHNOLOGY TO ACCELERATE AND IMPROVE PATIENT RECOVERY AT HOME.