2021-10-29T12:19:58-05:00 2020-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2020-01-01 455563741 WENATCHEE VALLEY HOSPITAL WENA 5096638711 820 NORTH CHELAN AVE WENATCHEE WA 98801 PETER D RUTHERFORD MD CHIEF EXECUTIVE OFFICER 5096638711 2021-10-19 1 PETER RUTHERFORD MD 999009999 ROBERT GRANNUM P00355876 4252597227 2021-10-19 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PETER D RUTHERFORD MD 820 NORTH CHELAN AVE WENATCHEE WA 98801 249719921 0 X WWW.CONFLUENCEHEALTH.ORG X 2012 WA DEDICATED TO IMPROVING OUR PATIENTS' HEALTH BY PROVIDING SAFE, HIGH-QUALITY CARE. 15 15 1560 2 0 0 707933 12795269 292614833 236718567 244745 0 223940 206085 293791451 249719921 247018 236361 0 0 97989281 98881021 0 0 0 200683530 166425491 298919829 265542873 -5128378 -15822952 74949334 118760563 65702023 130494615 9247311 -11734052 X WE ARE DEDICATED TO IMPROVING OUR PATIENTS' HEALTH BY PROVIDING SAFE, HIGH-QUALITY CARE IN A COMPASSIONATE AND COST EFFECTIVE MANNER. 0 1 223096167 236361 235573495 WENATCHEE VALLEY HOSPITAL WAS DEVELOPED AND FORMED AS A MEANS TO FURTHER CONFLUENCE HEALTH. THE PURPOSES OF THE HOSPITAL ARE AS FOLLOWS:A. MAINTAIN THE AVAILABILITY AND ACCESS TO HIGH QUALITY, COST EFFECTIVE HEALTHCARE SERVICES FOR THE NORTH CENTRAL WASHINGTON (NCW) COMMUNITY;B. IMPROVE COORDINATION OF LIMITED HEALTH CARE RESOURCES AND MAXIMIZE THE EFFICIENCY OF THE HEALTH SYSTEM TO ACHIEVE THE MOST COST EFFECTIVE CARE THAT CAN BE DELIVERED;C. PRESERVE NCW COMMUNITY CONTROL OVER IMPORTANT CARE DECISIONS AND ENSURE NCW COMMUNITY INVOLVEMENT IN THE DEVELOPMENT OF THE MEDICAL INFRASTRUCTURE AND OVERSIGHT OF THE NCW COMMUNITY HEALTHCARE DELIVERY SYSTEM;D. ENHANCE THE PATIENT-PHYSICIAN RELATIONSHIP AND MAINTAIN THE HIGH QUALITY OF CARE AND BREADTH OF SERVICES THE NCW COMMUNITY CURRENTLY ENJOYS;E. IMPROVE TEAMWORK AND INTEGRATION ACROSS THE CONTINUUM OF CARE AND ENSURE THAT PHYSICIANS AND OTHER HEALTHCARE PROVIDERS LEAD CLINICAL DESIGNS AND CLINICAL DECISIONS;F. ENSURE THAT PHYSICIANS AND ADMINISTRATIVE LEADERS HAVE A SHARED VISION REGARDING THE NCW COMMUNITY HEALTH CARE DELIVERY SYSTEM;G. ENSURE THAT THE NCW COMMUNITY ECONOMY, JOBS, AND BUSINESS PARTNERS ARE PRESERVED AND CAN GROW WITH THE REGION IN A RESPONSIBLE WAY;H. DEVELOP A HIGH PERFORMING INTEGRATED HEALTH CARE DELIVERY SYSTEM FOR THE NCW COMMUNITY THAT COULD APPLY FOR AND BE SUCCESSFUL WITH CONTRACTS FROM MEDICARE SO THAT THE NEWLY CREATED HEALTH SYSTEM CAN BE IDENTIFIED AS AN ACCOUNTABLE CARE ORGANIZATION IF SO DESIRED AND POSITION THE HEALTH SYSTEM SO THAT IT COULD CONTRACT FOR THE OVERALL SYSTEM OF CARE AND BE SUCCESSFUL WITH NEWLY DEVELOPED RISK CONTRACTS BEING OFFERED BY COMMERCIAL INSURERS.I. ESTABLISH, EQUIP, OPERATE AND MAINTAIN BENEVOLENT AND CHARITABLE INSTITUTIONS FOR THE GIVING OF MEDICAL AND SURGICAL CARE TO THE SICK, WOUNDED AND SUFFERING IRRESPECTIVE OF SEX, MARITAL STATUS, DISABILITY, COLOR, RACE, RELIGIOUS BELIEVE, SEXUAL ORIENTATION, ECONOMIC STATUS, OR PECUNIARY CIRCUMSTANCES; ANDJ. CARRY ON ANY EDUCATIONAL ACTIVITIES, RELATED TO THE RENDERING OF CARE TO THE SICK AND INJURED OR THE PROMOTION OF HEALTH WHICH, IN THE OPINION OF THE BOARD OF DIRECTORS OF WVH, MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS, OR OTHER REQUIREMENTS THAT ARE OR CAN BE MADE AVAILABLE IN ACCORDANCE WITH THE LAWS OF THE STATE OF WASHINGTON.WENATCHEE VALLEY HOSPITAL OPERATES TEN RURAL HEALTH CLINICS IN TEN COMMUNITIES THROUGHOUT THE NCW COMMUNITY INCLUDING: WENATCHEE, MOSES LAKE, EAST WENATCHEE, CASHMERE, TONASKET, OROVILLE, OMAK, ROYAL CITY, WATERVILLE, AND BREWSTER, AS WELL AS OPERATES A 20-BED HOSPITAL FACILITY WHICH SERVES MEDICAL, SURGICAL AND REHABILITATION PATIENTS. WENATCHEE VALLEY HOSPITAL HAS ENTERED INTO PROFESSIONAL SERVICE AGREEMENTS WITH A MULTI-SPECIALTY PHYSICIAN GROUP THAT EMPLOYS OR OTHERWISE ENGAGES NEARLY 300 PRIMARY CARE PHYSICIANS, PHYSICIAN SPECIALISTS AND MID-LEVEL PRACTITIONERS TO SERVE THE NEEDS OF PATIENTS WITHIN THE NCW COMMUNITY.WENATCHEE VALLEY HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE ASSOCIATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL SYSTEM MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES.MANAGEMENT ESTIMATES CHARITY CARE COSTS BY CALCULATING A RATIO OF COST TO GROSS CHARGES, AND THEN MULTIPLYING THAT RATIO BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. CHARITY CARE COSTS WERE $3,606,825 IN 2020.THE HOSPITAL HAD 1,987 ACUTE REHAB DAYS, 1,499 EMERGENCY VISITS, PROVIDED 5,214 SURGERY CASES AND A 631,389 OUTPATIENT COUNT. 223096167 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 63 0 1 1560 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 1 1 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TOM LEGEL 5096621511 1201 SOUTH MILLER STREET WENATCHEE WA 98801 ABE SOROM MD SECRETARY 1.00 3.00 X X 0 9600 0 GUS HEINICKE TREASURER 1.00 3.00 X X 0 7200 0 PATRICIA WACHTEL CHAIR 1.00 3.00 X X 0 7200 0 DOUG SHAE VICE CHAIR 1.00 3.00 X X 0 3600 0 GAUTAM NAYAK MD BOARD OF DIRECTORS 1.00 2.00 X 0 9600 0 JAMES MURRAY MD BOARD OF DIRECTORS 1.00 2.00 X 0 9600 0 DAN BROWN MD BOARD OF DIRECTORS (FROM 02/20) 1.00 2.00 X 0 9600 0 CATHERINE RIDGEWAY MD BOARD OF DIRECTORS (FROM 02/20) 1.00 2.00 X 0 9600 0 MITCHELL GARRISON MD BOARD OF DIRECTORS 1.00 2.00 X 0 7200 0 GARN CHRISTENSEN BOARD OF DIRECTORS 1.00 2.00 X 0 7200 0 JENNY CRAVENS BOARD OF DIRECTORS 1.00 2.00 X 0 7200 0 ROBERT TRASK JR BOARD OF DIRECTORS 1.00 2.00 X 0 7200 0 SCOTT DUNCAN BOARD OF DIRECTORS 1.00 2.00 X 0 7200 0 VICKY SCHARLAU BOARD OF DIRECTORS (FROM 02/20) 1.00 2.00 X 0 6600 0 KRISTINE LOOMIS BOARD OF DIRECTORS (THRU 06/20) 1.00 2.00 X 0 3600 0 CORI BAUTISTA BOARD OF DIRECTORS (FROM 08/20) 1.00 2.00 X 0 3000 0 TOBY BOND MD BOARD OF DIRECTORS (THRU 01/20) 1.00 2.00 X 0 0 0 DOUG WILSON MD BOARD OF DIRECTORS (THRU 01/20) 1.00 2.00 X 0 0 0 PETER RUTHERFORD CHIEF EXECUTIVE OFFICER 15.00 35.00 X 0 635691 39616 JASON M LAKE MD CHIEF MEDICAL OFFICER - WVMG 15.00 35.00 X 0 562099 46620 GLENN W ADAMS CHIEF OPERATING OFFICER 15.00 35.00 X 0 394770 45622 STUART D FREED MD MED DIR PHY LDRSHIP DEVLP 15.00 35.00 X 0 398380 27527 CORY M FERARI-ZIMMERMAN INTERIM CFO (THRU 03/20) 15.00 35.00 X 0 365035 39283 ROBERT J PAGELER CHIEF INFORMATION OFFICER 15.00 35.00 X 0 360268 29804 THOMAS J LEGEL CHIEF FINANCIAL OFFICER (FROM 03/20) 15.00 35.00 X 0 348655 16071 JOHN R DOYLE CHIEF FINANCIAL OFFICER (THRU 05/20) 15.00 35.00 X 0 127365 5095 CATHERINE J BROWN DNS, HOSPITAL ADMIN - WVH 25.00 25.00 X 0 88222 29449 TRACEY A KASNIC CNO, HOSPITAL ADMIN - CWH 15.00 35.00 X 0 379422 33108 JEANINE M ALLEN SR VP CWH OUTP SVCS (THRU 06/20) 15.00 35.00 X 0 378255 38793 SARAH A BATTIS JOHNSON SR VP QUAL CARE TRNSFRMTN 15.00 35.00 X 0 248367 27227 JOELLEN COLSON SR VP ANCILLARY SERVICES 15.00 35.00 X 0 257213 15767 JAY H JOHNSON SR VP NETWORK STRATEGY 15.00 35.00 X 0 243782 27559 STACI JONES SR VP SPECIALTY CARE 15.00 35.00 X 0 173063 31037 NICOLE M ANDERSON ARNP - OB-GYN 50.00 X 313544 0 42197 MAUVIA A SORENSEN ARNP - BEHAVIORAL HEALTH 50.00 X 241158 0 37049 MICHAEL D SIEG PHARMACY DIRECTOR 50.00 X 234292 0 40398 AARON C LEWIS MD PHYSICIAN 50.00 X 239243 0 7175 ANTHONY D CHAMBERS PA-C OCC MED 50.00 X 209050 0 27690 JAMES B WOOD FORMER CHIEF ADMIN OFFICER 0.00 X 0 529269 0 FARAZ S AHMED FORMER VP SR PRIMARY CARE 0.00 X 0 216297 0 1237287 5821353 607087 141 1 1 1 WENATCHEE VALLEY MEDICAL GROUP 820 N CHELAN AVE WENATCHEE WA 98801 CONTRACTING SERVICES 69100737 RADIA INC PS 19020 33RD AVE W STE 210 LYNWOOD WA 98036 PHYSICIAN SERVICES 2173543 UNIVERSITY OF WASHINGTON PO BOX 24366 SEATTLE WA 24366 LAB WORK SERVICES 2057382 VK POWELL CONSTRUCTION LLC PO BOX 10295 YAKIMA WA 98909 CONSTRUCTION SERVICES 1300433 WENATCHEE EMERGENCY SERVICES PO BOX 4600 WENATCHEE WA 98807 PHYSICIAN SERVICES 1049996 49 12374553 420716 12795269 PATIENT SERVICES 900099 223080596 223080596 MANAGED CARE 900099 7545235 7545235 PROFESSIONAL SERVICES 900099 2282751 2282751 RESEARCH 541700 1709373 1709373 ANCILLARY SERVICES 900099 710122 710122 1390490 952633 437857 236718567 206085 0 206085 206085 206085 249719921 235573495 0 1354064 236361 236361 73290684 58632547 14658137 3654861 2923889 730972 16013665 12810932 3202733 5921811 4737449 1184362 31827501 28644751 3182750 5340 5340 378856 378856 36728 25710 11018 146904 117523 29381 5543074 4434458 1108616 852875 682300 170575 9547531 8592778 954753 314288 251430 62858 1040011 1040011 2347921 2113129 234792 2455759 2455759 PATIENT SERVICES 87025296 78322766 8702530 GENERAL SERVICES 17910912 12537638 5373274 BAD DEBT EXPENSE 4316512 4316512 TAXES AND LICENSES 2675983 2675983 265542873 223096167 42446706 0 4799149 11588880 44783034 29528452 724577 1265502 1552959 1762411 36587747 15282538 19062016 21305209 0 2000000 4027599 51310109 74949334 118760563 26218252 21651349 0 13415367 0 52710534 39483771 42717365 65702023 130494615 X 9247311 -11734052 9247311 -11734052 74949334 118760563 X -15822952 -5158411 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 19240 19240 0 PART II-B, LINE 1: WA STATE HOSPITAL ASSOCIATION DUES - 20.50% OF $72,653 = $14,894 AMERICAN HOSPITAL ASSOCIATION DUES - 22.73% OF $19,119 = $4,346 TOTAL $19,240 239994 239994 4060239 906557 3153682 21507187 14203659 7303528 10780327 172322 10608005 21305209 CASCADE MEDICAL CENTER HOSPITAL BED LICENSES 3900929 RIGHT OF USE ASSETS 47409180 51310109 DUE TO AFFILIATES 22805672 NOTE PAYABLE - CWH 19911693 42717365 X PART X, LINE 2: THE HEALTH SYSTEM IS FORMED AS THREE SEPARATE NOT-FOR-PROFIT CORPORATIONS, WHICH HAVE BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HEALTH SYSTEM IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. ANY UNRELATED BUSINESS INCOME GENERATED IS NOT SIGNIFICANT; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. THE HEALTH SYSTEM HAS ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF DECEMBER 31, 2020 AND 2019, THE HEALTH SYSTEM HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. 1 1 X 1 X 175.000000000000 1 X 1 1 0 0 1967916 1967916 0.00750 42246049 25754018 16492031 0.06310 44213965 25754018 18459947 0.07060 1761579 1761579 0.00670 8549743 5755720 2794023 0.01070 63737 63737 0.00020 10375059 5755720 4619339 0.01760 54589024 31509738 23079286 0.08820 1 4316512 31384189 42635308 -11251119 X 1 1 1 1 WENATCHEE VALLEY HOSPITAL 820 NORTH CHELAN AVE WENATCHEE WA 98801 WWW.CONFLUENCEHEALTH.ORG HAC.FS.60424211 X X X X X WENATCHEE VALLEY HOSPITAL 1 0 0 1 X X X X X X X X 19 1 1 1 1 X WWW.CONFLUENCEHEALTH.ORG/ABOUT-US/ X 1 19 1 SEE PART V, PAGE 8 0 1 X 175.000000000000 300.000000000000 X X X X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X 1 X 0 X X X 1 X 0 0 WENATCHEE VALLEY HOSPITAL PART V, SECTION B, LINE 5: DURING JUNE AND AUGUST 2019, SIX COMMUNITY FOCUS GROUPS WERE HELD THROUGHOUT THE NORTH CENTRAL WASHINGTON REGION WITH AT LEAST ONE FOCUS GROUP IN EACH COUNTY (I.E. CHELAN-DOUGLAS, GRANT, AND OKANOGAN). EACH FOCUS GROUP WAS ATTENDED BY COMMUNITY STAKEHOLDERS FROM A VARIETY OF ORGANIZATIONS AND SECTORS (E.G. EDUCATION, HEALTHCARE, SOCIAL SERVICES). THE FOCUS GROUPS UTILIZED THE SWOT (STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS) ANALYSIS TO IDENTIFY THE HEALTH-RELATED STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS. EACH SWOT QUESTION WAS LED BY A FACILITATOR WHO GUIDED DISCUSSION AND RECORDED ANSWERS SHARED BY PARTICIPANTS. THE COMMUNITY VOICE SURVEY FROM THE 2016 CHNA WAS USED AGAIN IN THE 2019 CHNA WITH THE ADDITION OF ONE QUESTION. A QUESTION ABOUT HEALTH INSURANCE WAS ADDED TO BETTER INFORM THE DEMOGRAPHICS; TRACKING RESPONSES OF HIGH NEEDS INDIVIDUALS. THE SURVEY CONSISTED OF 15 QUESTIONS AND WAS OPEN FOR THREE MONTHS (FEBRUARY 14 TO MAY 9, 2019).THE SURVEY WAS OFFERED IN ENGLISH AND SPANISH. IT WAS ADMINISTERED USING SURVEYMONKEY (AN ONLINE SURVEY TOOL). PAPER COPIES WERE PROVIDED AT VARIOUS ORGANIZATIONS THROUGHOUT THE REGION. DIRECT SURVEY OUTREACH ALSO OCCURRED AT SOME OF THE REGIONAL FOOD BANKS. 5,010 NORTH CENTRAL WASHINGTON RESIDENTS FILLED OUT THE SURVEY, REPRESENTING A VARIETY OF SECTORS; 33% IDENTIFYING AS COMMUNITY MEMBERS.THE SURVEY CAPTURED THE OPINIONS OF THE HEALTH OF THE COMMUNITY, THE FACTORS TO IMPROVE HEALTH, THE GREATEST RISKS TO HEALTH AND THE BEHAVIORS IN THE COMMUNITY THAT POSITIVELY OR NEGATIVELY AFFECT HEALTH.ORGANIZATIONS CONSULTED: ACTION HEALTH PARTNERS, AGING AND ADULT CARE, AMERIGROUP, BEACON HEALTH OPTIONS, CASCADE MEDICAL CENTER, CASCADE UNITARIAN UNIVERSALIST FELLOWSHIP, CATHOLIC CHARITIES, CENTRAL WASHINGTON SLEEP, DIAGNOSTIC CENTER, CHELAN SENIOR CENTER, CHELAN-DOUGLAS COMMUNITY ACTION COUNCIL, CHELAN-DOUGLAS HEALTH DISTRICT, CHELAN-DOUGLAS TRANSPORTATION COUNCIL, CHILDREN'S HOME SOCIETY WASHINGTON, CITY OF EAST WENATCHEE, CITY OF WENATCHEE, COLUMBIA BASIN HOSPITAL, COLUMBIA VALLEY COMMUNITY HEALTH, CONFLUENCE HEALTH, CONFLUENCE HEALTH FOUNDATION, COORDINATED CARE, GRAND COULEE DAM SCHOOL DISTRICT, GRANT COUNTY HEALTH DISTRICT, GRANT INTEGRATED SERVICES, LAKE CHELAN COMMUNITY HOSPITAL, LAKE CHELAN HEALTH & WELLNESS FOUNDATION, MATTAWA COMMUNITY MEDICAL CLINIC, MATTAWA POLICE, MICROSOFT, MID-VALLEY HOSPITAL, MOLINA HEALTHCARE, MOSES LAKE COMMUNITY HEALTH CENTER, NEW HOPE, NORTH CENTRAL ACCOUNTABLE COMMUNITY OF HEALTH, NORTH CENTRAL EDUCATIONAL SERVICE DISTRICT, NORTH CENTRAL REGIONAL LIBRARY, NORTH VALLEY HOSPITAL, OKANOGAN COUNTY COMMUNITY ACTION COUNCIL, OKANOGAN COUNTY PUBLIC HEALTH, OKANOGAN COUNTY TRANSIT, OKANOGAN JUVENILE DETENTION, PARKVIEW MEDICAL GROUP, QUINCY PARTNERSHIP FOR YOUTH, ROOM ONE, SAMARITAN HEALTHCARE, SKILLSOURCE ,TENDER LOVING CARE ,THREE RIVERS HOSPITAL, TOGETHER! FOR YOUTH, UPPER VALLEY MEND, WAHLUKE COMMUNITY COALITION, WASHINGTON STATE UNIVERSITY EXTENSION, WENATCHEE VALLEY DISPUTE RESOLUTION CENTER, WOMEN'S RESOURCE CENTER, WORKSOURCE WENATCHEE VALLEY HOSPITAL PART V, SECTION B, LINE 6A: CENTRAL WASHINGTON HOSPITAL WENATCHEE VALLEY HOSPITAL PART V, SECTION B, LINE 6B: ACTION HEALTH PARTNERSCHELAN-DOUGLAS HEALTH DISTRICTCONFLUENCE HEALTH WENATCHEE VALLEY HOSPITAL PART V, SECTION B, LINE 11: THERE WERE FIVE SIGNIFICANT NEEDS IDENTIFIED IN THE 2019 CHNA:1) CHRONIC HEALTH - CONFLUENCE HEALTH CONTINUES TO INVEST AND PARTICIPATE IN PROGRAMS THAT ARE COMMUNITY BASED AND WHICH TARGET DIABETICS AND THOSE PATIENTS AT RISK OF DEVELOPING DIABETES. CH STAFF WILL CONTINUE TO ENGAGE IN EDUCATION AND OUTREACH IN THE COMMUNITY SETTING (E.G. COOKING CLASSES AT PYBUS MARKET, GROUP EDUCATION COURSES, SCHOOL OUTREACH) TO PROMOTE EDUCATION AND EMPOWER PATIENTS TO LEARN WAYS TO SELF-MANAGE THEIR DIABETES.CONFLUENCE HEALTH WILL ALSO CONTINUE TO INVEST IN DEVELOPING SUSTAINABLE CARE MODELS FOR DELIVERY OF CARE TO PATIENTS DIAGNOSED WITH, OR AT RISK OF DEVELOPING, DIABETES. WEIGHT MANAGEMENT INITIATIVES WILL CONTINUE TO INCLUDE EMOTIONAL AND BEHAVIORAL HEALTH EDUCATION TO ADDRESS MOTIVATION AS WELL AS DIABETES-RELATED DISTRESS (I.E. EMOTIONAL RESPONSES RELATED TO THE DISEASE). THIS SUPPORT INCLUDES INTERVENTION STRATEGIES TO PROMOTE PATIENT ENGAGEMENT AND SELF-MANAGEMENT.CONFLUENCE HEALTH WILL CONTINUE TO REFINE PROCESSES FOR IDENTIFYING PATIENTS SEEN IN THE PRACTICE WHO ARE AT HIGH RISK ACCORDING TO ADA RECOMMENDATIONS. SCREENING WILL OCCUR IN ALL PATIENT CARE AREAS AND APPROPRIATE FOLLOW UP WILL BE PROVIDED. TO DELIVER THIS CARE, THE ORGANIZATION WILL CONTINUE TO DEVELOP AND EDUCATE ON THE CONSISTENT USE OF TREATMENT ALGORITHMS FOR PATIENTS WITH DIABETES. CARE TEAMS AND PATIENTS WILL DETERMINE MUTUALLY AGREED-UPON TREATMENT PLANS AND GOALS WILL BE INDIVIDUALIZED TO EACH PATIENT'S NEEDS.CONFLUENCE HEALTH CONTINUES TO INVEST IN TRAINING CARE TEAM MEMBERS WHO SHOULD, THROUGH TRAINING, BE AWARE OF THE IMPORTANCE OF HYPERTENSION MANAGEMENT AND BLOOD PRESSURE GOALS. TEAM MEMBERS SHOULD BE ENCOURAGED TO COMMENT TO PATIENTS ON THEIR PROGRESS AND ON THE IMPORTANCE OF MEDICATIONS AND MEDICATION ADHERENCE, ESPECIALLY WHEN PATIENTS ARE NOT AT GOAL. THIS FOCUS WILL ENSURE APPROPRIATE MEASUREMENT OF A PATIENT'S BLOOD PRESSURE AND IMPROVE PROVIDER DECISIONS WHEN DELIVERING TREATMENT.ENSURING CONSISTENT MEASUREMENT OF A PATIENT'S CONDITION AT ALL VISITS THROUGHOUT THE SYSTEM IS KEY. THROUGH THIS MEASUREMENT, APPROPRIATE CATEGORIZATION AND ASSESSMENT OF PATIENTS LEADS TO BETTER CARE DELIVERY. ALTHOUGH PATIENTS WITH HYPERTENSION MAY VISIT A PRIMARY CARE PHYSICIAN OR SPECIALIST FOR NON-HYPERTENSION CHIEF COMPLAINT, STANDARDIZED PROCESSES ARE IN PLACE TO ASSURE HYPERTENSION IS EVALUATED AND/OR TREATED AT EVERY VISIT.2) ACCESS TO HEALTHCARE INCLUDING BEHAVIORAL HEALTH - CONFLUENCE HEALTH WILL CONTINUE TO PROVIDE MEDICATION MANAGEMENT SERVICES TO OUR REMOTE SITES IN NORTH COUNTRY. CONFLUENCE HEALTH WILL IMPLEMENT THE COLLABORATIVE CARE MODEL IN OUR OMAK CLINIC. THE COLLABORATIVE CARE MODEL HAS THE MOST EVIDENCE AMONG INTEGRATION MODELS TO DEMONSTRATE ITS EFFECTIVE AND EFFICIENT INTEGRATION IN TERMS OF CONTROLLING COSTS, IMPROVING ACCESS, IMPROVING CLINICAL OUTCOMES, AND INCREASING PATIENT SATISFACTION IN RURAL PRIMARY CARE SETTINGS. CONFLUENCE HEALTH STAYS COMMITTED TO OFFERING GROUP THERAPY AS A TREATMENT OPTION. GROUPS CAN OFFER MANY BENEFITS TO THE PATIENT INCLUDING INCREASED ACCESS TO CARE. A THERAPY GROUP PROVIDES AN OPPORTUNITY FOR PEOPLE TO SHARE WITH EACH OTHER PERSONAL EXPERIENCES AND FEELINGS, COPING STRATEGIES OR FIRSTHAND INFORMATION ABOUT DISEASES OR TREATMENTS.CONFLUENCE HEALTH IS COMMITTED TO PROVIDING CARE TO ALL PATIENTS IN A TIMELY MANNER. ONE OF THE MOST IMPORTANT FEATURES OF THIS COMMITMENT IS OUR COMPASSIONATE CARE PROGRAM, IN WHICH WE WORK WITH PATIENTS TO COVER SOME OR ALL COSTS. IN 2019 WE PROVIDED $15,000,000 OF CARE THROUGH THIS PROGRAM, WHICH EQUATE TO ABOUT 25,000 PATIENT ACCOUNTS. THERE IS CLEAR EVIDENCE THAT LOWER INCOME PATIENTS HAVE LOWER RATES OF HEALTH CARE USAGE, ACCORDING TO THE CDC, AND WE WANT TO ENSURE THAT ALL PATIENTS RECEIVE APPROPRIATE CARE REGARDLESS OF COST.IN ADDITION, WE WANT TO ENSURE THAT ALL PATIENTS ARE TREATED EQUALLY AND FEEL WELCOME TO RECEIVE CARE ACROSS ALL SITES IN CONFLUENCE HEALTH. IN 2016, WE STARTED A HEALTH, EQUITY, DIVERSITY AND INCLUSION PROGRAM WHICH NOW WORKS TO ADDRESS AND IMPROVE ISSUES OF DIVERSITY AND INCLUSION FOR PATIENTS AND STAFF. THIS ROBUST PROGRAM WILL CONTINUE TO GROW AND HELP CARE FOR ALL PATIENTS.AVAILABILITY OF PRIMARY CARE PROVIDERS REMAINS AN ONGOING ISSUE, AND CONFLUENCE CONTINUES TO COMMIT SIGNIFICANT EFFORTS TO RECRUITING MORE PROVIDERS. IN 2019, WE HIRED 29 NEW PRIMARY CARE PROVIDERS AT CONFLUENCE HEALTH AND CONTINUE OUR RECRUITING EFFORTS ACROSS OUR SYSTEM.CONFLUENCE HEALTH IS ALSO CONTINUING TO IMPROVE THE AVAILABILITY OF APPOINTMENTS IN PRIMARY CARE CLINICS. SEVERAL OF OUR PROVIDERS HAVE TRANSITIONED TO OPEN ACCESS MODELS WHERE VIRTUALLY ALL APPOINTMENTS ARE BOOKED WITHIN 24 HOURS. WE ARE COMMITTED TO EXPANDING THIS MODEL TO ADDITIONAL PRACTICES. FURTHERMORE, WE OFFER VIRTUAL (PHONE) VISITS AND ARE WORKING TO EXPAND THESE OPTIONS AS WELL. FINALLY, WE WILL EXPLORE TELEHEALTH AS AN OPTION FOR PRIMARY CARE VISITS WHICH IS PARTICULARLY IMPORTANT FOR PATIENTS WHO TRAVEL LONG DISTANCES FOR CARE.AS WE MOVE FORWARD, WE AIM TO CONTINUE TO DEVELOP COMMUNITY PARTNERSHIPS THAT WILL EXPAND OUR CARE DELIVERY OPTIONS AND SERVICES PROVIDED. SOMETIMES ACCESS TO CARE MAY INCLUDE EXERCISE PRESCRIPTIONS, DIETARY COUNSELING, OR MEDICATION MANAGEMENT WHICH CAN ALL BE PROVIDED BY CARE TEAMS. FURTHERMORE, WE UNDERSTAND THAT ONLINE SCHEDULING AND APPOINTMENT AVAILABILITY THOUGHT ONLINE PORTALS CAN HELP WITH ACCESS AS WELL. WE WILL CONTINUE TO IMPROVE THESE OPTIONS AS WELL.3) EDUCATION - CONFLUENCE HEALTH CONTINUES TO INVEST AND PARTICIPATE IN EDUCATIONAL PROGRAMS THAT ARE COMMUNITY BASED, WHICH TARGET SPECIFIC HEALTH RELATED CONDITIONS. CONFLUENCE HEALTH STAFF WILL CONTINUE TO ENGAGE THE COMMUNITY IN EDUCATION AND OUTREACH IN THE COMMUNITY SETTING (E.G. COOKING CLASSES AT PYBUS MARKET, GROUP EDUCATION COURSES, SCHOOL OUTREACH) TO PROMOTE EDUCATION AND EMPOWER PATIENTS TO LEARN WAYS TO SELF-MANAGE THEIR HEALTH.4) SUBSTANCE ABUSE - CONFLUENCE HEALTH CONTINUES TO INVEST AND PARTICIPATE IN PROGRAMS THAT ARE COMMUNITY BASED WHICH WILL TARGET PATIENTS, AND COMMUNITY MEMBERS, CURRENTLY, OR AT RISK OF, OPIOID OR ALCOHOL ABUSE.5) AFFORDABLE HOUSING - CONFLUENCE HEALTH WILL CONTINUE TO PARTNER WITH LOCAL ADVOCACY GROUPS TO ADDRESS AFFORDABLE HOUSING. THESE PARTNERSHIPS MAY TAKE VARIOUS FORMS INCLUDING, BUT NOT LIMITED TO, HOUSING TASK FORCES WITHIN THE COMMUNITIES CONFLUENCE HEALTH SERVES, COORDINATING WITH LOCAL HOTELS TO OFFER DISCOUNTED RATES FOR PATIENTS, AND FAMILY MEMBERS.CONFLUENCE HEALTH WILL ALSO CONTINUE TO ENSURE ACTIVE LEADERSHIP REPRESENTATION ON HOUSING TASK FORCES AND/OR ADVOCACY GROUPS. WENATCHEE VALLEY HOSPITAL PART V, SECTION B, LINE 13B: THE INDIVIDUAL FINANCIAL CIRCUMSTANCES STATED IN THE WRITTEN FINANCIAL POLICY IS TO TAKE INTO CONSIDERATION THE PATIENT/GUARANTOR'S ASSETS AND THEIR ABILITY TO PAY. WENATCHEE VALLEY HOSPITAL PART V, SECTION B, LINE 13H: COMPASSIONATE CARE IS GENERALLY CONSIDERED ONLY AFTER ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT HAVE BEEN EXPLORED AND EXHAUSTED. IN ORDER TO QUALIFY FOR COMPASSIONATE CARE, THE PATIENT/GUARANTOR MUST FULLY COOPERATE WITH THE HOSPITAL IN EXPLORING AND APPLYING FOR THESE RESOURCES. OTHER FINANCIAL RESOURCES INCLUDE BUT ARE NOT LIMITED TO: GROUP OR INDIVIDUAL MEDICAL PLANS, SECONDARY OR SUPPLEMENTAL INSURANCE POLICIES, WORKER'S COMPENSATION, MEDICARE, MEDICAID OR MEDICAL ASSISTANCE PROGRAMS, OTHER STATE, FEDERAL OR MILITARY PROGRAMS, THIRD PARTY LIABILITY SITUATIONS (E.G. AUTO ACCIDENTS OR PERSONAL INJURIES), OR ANY OTHER SITUATION IN WHICH ANOTHER PERSON OR ENTITY MAY HAVE A LEGAL RESPONSIBILITY TO PAY FOR THE COSTS OF MEDICAL SERVICES.COMPASSIONATE CARE FOR NON-EMERGENT SERVICES SHALL BE LIMITED TO THOSE RESIDING WITH THE HOSPITALS DESIGNATED SERVICE AREA, WHICH IS DEFINED AS THE COUNTIES OF CHELAN, DOUGLAS, GRANT AND OKANOGAN AS WELL AS THE TOWN OF OTHELLO. NON-EMERGENT SERVICES SHALL BE DEFINED AS THOSE SERVICES WHICH ARE NOT CONSIDERED AS AN "EMERGENCY MEDICAL CONDITION" UNDER THE POLICY'S DEFINITION.COMPASSIONATE CARE SHALL BE LIMITED TO "APPROPRIATE HOSPITAL (PHYSICIAN)-BASED MEDICAL SERVICES" AS DEFINED IN THE POLICY. ELECTIVE OR COSMETIC PROCEDURES THAT DO NOT MEET THE DEFINITION OF APPROPRIATE AS SET FORTH IN THE WA ADMINISTRATIVE CODE (WAC) 246-453-010(7) ARE EXCLUDED AS WELL AS PROCEDURES DONE OUTSIDE OF THE HOSPITAL.IN THOSE SITUATIONS, WHERE APPROPRIATE PRIMARY PAYMENT SOURCES ARE NOT AVAILABLE, OR IN CERTAIN SITUATIONS WHEN THE PRIMARY PAYMENT SOURCE LEAVES A BALANCE THAT IS THE PATIENT'S LIABILITY, PATIENTS WILL BE CONSIDERED FOR COMPASSIONATE CARE UNDER THE POLICY.OTHER ELIGIBILITY CRITERIA INCLUDES CIRCUMSTANCES THAT INDICATE SEVERE FINANCIAL HARDSHIP OR PERSONAL LOSS. PART V, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.CONFLUENCEHEALTH.ORG/ABOUT-US/ANNUAL-REPORTS/ PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.CONFLUENCEHEALTH.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE/CHARITY-CARE/ELIGIBILITY-INELIGIBLE-SERVICES/ PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.CONFLUENCEHEALTH.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE/CHARITY-CARE/APPLICATION-PROCESS/ PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.CONFLUENCEHEALTH.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE/CHARITY-CARE/ELIGIBILITY-INELIGIBLE-SERVICES/ 21 1 - MOSES LAKE CLINIC 840 E HILL AVE MOSES LAKE WA 98837 MULTISPECIALTY CLINIC, AMBULATORY SURGERY CENTER, WALK-IN CLINIC 2 - OMAK CLINIC AND REGIONAL EYE CENTER 916 KOALA DRIVE OMAK WA 98841 MULTISPECIALTY CLINIC, WALK-IN CLINIC 3 - EAST WENATCHEE CLINIC 100 HIGHLINE DRIVE EAST WENATCHEE WA 98802 FAMILY MEDICINE, BEHAVIORAL, LAB & PATHOLOGY, RADIOLOGY/IMAGING 4 - WENATCHEE ORTHOPEDICS BUILDINGS 520 N CHELAN AVE WENATCHEE WA 98801 ORTHOPEDICS CLINIC 5 - MILLER STREET COMPLEX 1000 N MILLER ST WENATCHEE WA 98801 PHYSICAL THERAPY AND SLEEP CENTER 6 - BREWSTER CLINIC 418 W MAIN STREET BREWSTER WA 98812 FAMILY MEDICINE/PRIMARY CARE, CARDIOLOGY, DERMATOLOGY, & EAR/NOSE/THROAT 7 - PEDIATRICS BUILDING 900 N MISSION STREET WENATCHEE WA 98801 OUTPATIENT PEDIATRICS 8 - TONASKET CLINIC 17 SOUTH WESTERN AVE TONASKET WA 98855 FAMILY MEDICINE AND PRIMARY CARE CLINIC 9 - OCCUPATIONAL MEDICINE 317 N MISSION STREET WENATCHEE WA 98801 OCCUPATIONAL MEDICINE 10 - MOSES LAKE THERAPY SERVICES BUILDING 938 W 3RD AVE MOSES LAKE WA 98837 PHYSICAL THERAPY 11 - EPHRATA CLINIC 314 BASIN SW EPHRATA WA 98823 FAMILY MEDICINE/PRIMARY CARE CLINIC, DIAGNOSTIC & THERAPUTIC SERVICES 12 - METHOW VALLEY CLINIC 1116 WA-20 WINTHROP WA 98862 FAMILY MEDICINE AND PEDIATRICS 13 - CASHMERE CLINIC 303 COTTAGE AVENUE CASHMERE WA 98815 FAMILY MEDICINE AND PRIMARY CARE CLINIC 14 - OROVILLE CLINIC 1617 MAIN ST OROVILLE WA 98844 FAMILY MEDICINE AND PRIMARY CARE CLINIC 15 - STEMILT CLINIC 2833 EUCLID AVE WENATCHEE WA 98801 STEMILT PRIMARY CARE CLINIC 16 - BEHAVIORAL HEALTH BUILDING 966 S JUNIPER DR MOSES LAKE WA 98837 BEHAVIORAL HEALTH SERVICES 17 - SAMARITAN CLINIC 1550 S PIONEER WAY MOSES LAKE WA 98837 OPHTHALMOLOGY, OPTOMETRY, AND REHABILITATION 18 - WATERVILLE CLINIC 117 SOUTH CHELAN AVE WATERVILLE WA 98858 FAMILY MEDICINE AND PRIMARY CARE CLINIC 19 - ROYAL CITY CLINIC 103 CAMELIA ST NW ROYAL CITY WA 99357 FAMILY MEDICINE AND PRIMARY CARE CLINIC 20 - ANTI-COAG BUILDING 986 S JUNIPER DR MOSES LAKE WA 98837 ANTICOAGULATION 21 - MOSES LAKE SPECIALTY CARE CLINIC 1345 YONEZAWA BLVD MOSES LAKE WA 98837 GENERAL & VASCULAR SURGERY, OPTHALMOLOGY, OPTOMETRY PART I, LINE 3C: CONFLUENCE HEALTH 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, COLUMN (F): BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN: $4,316,512. PART III, LINE 2: NET PATIENT SERVICE REVENUE - THE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT 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. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.PATIENT ACCOUNTS RECEIVABLE - FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 4: PATIENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT, RESIDENT, CUSTOMER, AND THIRD-PARTY PAYOR OBLIGATIONS. PAYMENTS OF PATIENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM. THE CARRYING AMOUNT OF PATIENT RECEIVABLES IS REDUCED BY IMPLICIT AND EXPLICIT PRICE CONCESSIONS THAT REFLECTS MANAGEMENT'S ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS, AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS DUE TO IMPLICIT PRICE CONCESSIONS. MANAGEMENT CONSIDERS HISTORICAL WRITE-OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED IMPLICIT PRICE CONCESSION. RECEIVABLES ARE REDUCED BY AN ESTIMATED IMPLICIT PRICE CONCESSION. IN EVALUATING THE COLLECTIBILITY OF RECEIVABLES, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ESTIMATED IMPLICIT PRICE CONCESSION. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ESTIMATED IMPLICIT PRICE CONCESSION. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ESTIMATED IMPLICIT PRICE CONCESSION, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HEALTH SYSTEM RECORDS A SIGNIFICANT IMPLICIT PRICE CONCESSION IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ESTIMATED IMPLICIT PRICE CONCESSION. THE HEALTH SYSTEM'S SELF-PAY WRITE-OFFS WERE $4,316,512 AND $4,510,582 FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019, RESPECTIVELY. PART III, LINE 8: MEDICARE - INPATIENT ACUTE CARE SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. NET REVENUE BILLED UNDER THE MEDICARE PROGRAM TOTALED APPROXIMATELY $73,108,150 AND $97,609,000 FOR 2020 AND 2019, RESPECTIVELY. PART III, LINE 9B: IT IS THE POLICY TO WORK WITH THE PATIENT TO OBTAIN PAYMENT IN FULL, SECURE FINANCIAL ASSISTANCE, OR ESTABLISH APPROPRIATE PAYMENT ARRANGEMENTS ON PATIENT BALANCES WITHIN 30 DAYS OF THE INITIAL STATEMENT DATE.1. WHEN POSSIBLE THE SCHEDULER, AND/OR RECEPTIONS, WILL ALERT THE PATIENT OF ANY SELF-PAY DEPOSIT, PRE-PAYMENT OR INSURANCE CO-PAYMENT, WHICH MAY BE REQUESTED AT THE TIME OF SERVICE.2. PAYMENT IN FULL ON ALL SELF-PAY BALANCES IS EXPECTED WITHIN 30 DAYS OF RECEIPT OF THE FIRST STATEMENT. THE RESPONSIBILITY FOR PAYMENT REMAINS WITH THE GUARANTOR. THE HOSPITAL DOES NOT BECOME INVOLVED IN DISPUTES THAT OCCUR AS A RESULT OF DIVORCE SETTLEMENTS, CHILD CUSTODY, AND ACCIDENTAL INJURY OR THIRD PARTY LITIGATION.3. WORKING WITH THE GUARANTOR, THE HOSPITAL WILL ESTABLISH PAYMENT ARRANGEMENTS WHEN PAYMENT IN FULL CANNOT BE MADE. COLLECTION EFFORTS ARE SUSPENDED WHEN THE GUARANTOR REQUESTS A FINANCIAL ASSISTANCE APPLICATION. THIS SUSPENSION IS IN EFFECT FOR 30 CALENDAR DAYS GIVING THE APPROPRIATE PARTY TIME TO COMPLETE THE APPLICATION AND PROVIDE THE REQUIRED DOCUMENTATION. COLLECTION EFFORTS REMAIN SUSPENDED UNTIL THE FINAL DETERMINATION OF QUALIFICATION IS COMPLETED.4. ALL TRANSACTIONS ARE REQUIRED TO AGE A MINIMUM OF 120 DAYS, ALLOWING FOR 4 STATEMENTS AND AT LEAST 1 LETTER, BEFORE BEING CONSIDERED FOR TRANSFER TO AN OUTSIDE COLLECTION AGENCY.5. IF AN ACCOUNT HAS A MAIL RETURN STATUS AND ALL STEPS TAKEN TO FIND THE ADDRESS WERE UNSUCCESSFUL THE ACCOUNT MAY BE TURNED TO COLLECTION FOR FURTHER RESEARCH. PART VI, LINE 2: WENATCHEE VALLEY HOSPITAL PARTICIPATED IN A COMMUNITY WIDE NEEDS ASSESSMENT IN COOPERATION WITH ACTION HEALTH PARTNERS, CHELAN-DOUGLAS HEALTH DISTRICT, AND CONFLUENCE HEALTH. PART VI, LINE 3: COMMUNICATIONS TO THE PUBLIC: INFORMATION ABOUT THE ASSOCIATION'S FINANCIAL ASSITANCE AND CHARITY CARE POLICY ALSO KNOWN AS COMPASSIONATE CARE PROGRAM (CCP) SHALL BE MADE PUBLICLY AVAILABLE AS FOLLOWS:1. A NOTICE ADVISING PATIENTS THAT THE HOSPITAL PROVIDES COMPASSIONATE CARE SHALL BE POSTED IN KEY PUBLIC AREAS OF THE FACILITY.2. THE ASSOCIATION WILL DISTRIBUTE A WRITTEN NOTICE ABOUT THE AVAILABILITY OF COMPASSIONATE CARE TO ALL PATIENTS AT THE TIME OF NEW PATIENT REGISTRATION THROUGH THE EMERGENCY DEPARTMENT AND DURING ADMISSIONS. THIS INFORMATION WILL ALSO BE AVAILABLE ON THE WEBSITE, WITH EACH BILLING STATEMENT, AND IN ANY COLLECTION LETTERS SENT BY THE ASSOCIATION.3. THE WRITTEN NOTICE SHALL BE AVAILABLE IN ANY LANGUAGE SPOKEN BY MORE THAN FIVE PERCENT OF THE POPULATION IN THE ASSOCIATION'S SERVICE AREA, AND INTERPRETED FOR OTHER NON-ENGLISH SPEAKING OR LIMITED-ENGLISH SPEAKING PATIENTS AND FOR OTHER PATIENTS WHO CANNOT UNDERSTAND THE WRITING AND/OR EXPLANATION. THE ASSOCIATION'S SERVICE AREA IS DEFINED AS; CHELAN, DOUGLAS, OKANOGAN AND GRANT COUNTIES. THE ASSOCIATION FINDS THAT FOLLOWING NO-ENGLISH TRANSLATION(S) OF THE NOTICE SHALL BE MADE AVAILABLE: SPANISH.4. THE ASSOCIATION WILL REFER ALL COMPASSIONATE CARE INQUIRIES TO THE FINANCIAL ASSISTANCE DEPARTMENT OR WHEN POSSIBLE DIRECTLY TO THE COMPASSIONATE CARE COORDINATOR SO THAT ALL CONCERNS CAN BE ADDRESSED IN A TIMELY MANNER.5. WRITTEN NOTICE ABOUT THE ASSOCIATION'S COMPASSIONATE CARE POLICY SHALL BE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION, EITHER BY MAIL, BY TELEPHONE OR IN PERSON. THE ASSOCIATION'S COMPASSIONATE CARE SLIDING SCALE DISCOUNT TABLE SHALL ALSO BE MADE AVAILABLE UPON REQUEST. PART VI, LINE 4: THE HOSPITAL OPERATES A 20-BED HOSPITAL ALONG WITH 13 MULTISPECIALTY OUTPATIENT CLINICS DELIVERING A FULL RANGE OF HEALTH CARE SERVICES IN WENATCHEE, WASHINGTON AND THE NORTH CENTRAL WASHINGTON AREA. THE HOSPITAL IS A NOT-FOR-PROFIT INSTITUTION GOVERNED BY A BOARD OF DIRECTORS, PROVIDING GENERAL INPATIENT AND REHAB SERVICES AS WELL AS ALLERGY, AUDIOLOGY, BEHAVIORAL MEDICINE, BREAST & CERVICAL HEALTH, BREAST IMAGING, CANCER CARE, CARDIOLOGY, CARDIOTHORACIC SURGERY, DERMATOLOGY, EAR, NOSE & THROAT, ENDOCRINOLOGY, FAMILY MEDICINE, GASTROENTEROLOGY, GERIATRICS, HOSPITAL SERVICES, INFECTIOUS DISEASE, INTERNAL MEDICINE, NEPHROLOGY, NEUROLOGY, NEUROSURGERY, NUTRITION, OCCUPATIONAL MEDICINE, OCCUPATIONAL THERAPY, ONCOLOGY & HEMATOLOGY, OPHTHALMOLOGY, OPTOMETRY, ORTHOPEDICS & ORTHOPEDIC SURGERY, PAIN MANAGEMENT, PALLIATIVE CARE, PEDIATRICS, PHYSIATRY, PHYSICAL THERAPY, PODIATRY, PULMONARY MEDICINE, RADIATION ONCOLOGY, RADIOLOGY/IMAGING, RESEARCH, RHEUMATOLOGY, ROBOTIC SURGERY, SLEEP CENTER, SPEECH LANGUAGE PATHOLOGY, SPINAL CLINIC & SURGERY, UROLOGY, VASCULAR SURGERY, WOMEN'S HEALTH AND WOUND CARE.WENATCHEE, WASHINGTON IS APPROXIMATELY 150 MILES EAST OF SEATTLE, WASHINGTON AND 170 MILES WEST OF SPOKANE, WASHINGTON. CHELAN AND DOUGLAS COUNTIES COMPRISE THE HOSPITAL'S PRIMARY SERVICE AREA WHILE GRANT AND OKANOGAN COUNTIES REPRESENT SECONDARY SERVICE AREAS. THE 13 MULTISPECIALTY OUTPATIENT CLINICS ARE LOCATED IN 11 CITIES. APPROXIMATELY 96% OF THE HOSPITAL'S PATIENT VISITS ARE FROM THE PRIMARY AND SECONDARY SERVICE AREAS. THE SERVICE AREA'S POPULATION IS HEAVILY WEIGHTED IN THE 65+ AGE COHORT. IN ADDITION, THE HOSPITAL HAS A HIGH CONCENTRATION OF FARM AND AGRICULTURE RELATED EMPLOYERS/EMPLOYEES. PART VI, LINE 5: THE HOSPITAL PARTNERS WITH CONFLUENCE HEALTH TO SERVE THE HEALTH OF THE COMMUNITY BY PROVIDING BENEFITS TO THE COMMUNITY INCLUDING EDUCATIONAL OPPORTUNITIES, CLINICS, AND FLU VACCINATIONS. PART VI, LINE 6: CONFLUENCE HEALTH WAS FORMED IN 2012 AS A HEALTH SYSTEM THAT REPRESENTS AN AFFILIATION BETWEEN THE HOSPITAL, WENATCHEE VALLEY MEDICAL GROUP (A FOR-PROFIT ORGANIZATION) AND CENTRAL WASHINGTON HOSPITAL. EFFECTIVE JANUARY 1, 2013, THE HOSPITAL AFFILIATED WITH CONFLUENCE HEALTH AND CONFLUENCE HEALTH BECAME THE SOLE MEMBER OF THE HOSPITAL. THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH CONSISTS OF 9 COMMUNITY MEMBERS AND 6 PHYSICIANS OF WENATCHEE VALLEY MEDICAL GROUP.THE MISSION STATEMENT OF CONFLUENCE HEALTH IS:WE ARE DEDICATED TO IMPROVING OUR PATIENTS HEALTH BY PROVIDING SAFE, HIGH-QUALITY CARE IN A COMPASSIONATE AND COST-EFFECTIVE MANNER. PART VI, LINE 7: N/A 1 CONFLUENCE HEALTH FOUNDATION 518 N CHELAN AVE WENATCHEE WA 98801 911075950 501(C)(3) 236361 GENERAL SUPPORT 1 0 PART I, LINE 2: WENATCHEE VALLEY HOSPITAL MAKES GRANTS ONLY TO AN ORGANIZATION WITH A SHARED ACCOUNTING OVERSIGHT FUNCTION. X X X 1 0 0 0 0 1 1 0 0 PETER RUTHERFORD CHIEF EXECUTIVE OFFICER 0 549507 0 62080 0 24104 0 20990 0 18626 0 675307 0 0 JASON M LAKE MD CHIEF MEDICAL OFFICER - WVMG 0 538091 0 24008 0 0 0 22018 0 24602 0 608719 0 0 GLENN W ADAMS CHIEF OPERATING OFFICER 0 356739 0 29762 0 8269 0 18935 0 26687 0 440392 0 0 STUART D FREED MD MED DIR PHY LDRSHIP DEVLP 0 349556 0 48824 0 0 0 12870 0 14657 0 425907 0 0 CORY M FERARI-ZIMMERMAN INTERIM CFO (THRU 03/20) 0 253081 0 111954 0 0 0 16096 0 23187 0 404318 0 0 ROBERT J PAGELER CHIEF INFORMATION OFFICER 0 328787 0 31481 0 0 0 16880 0 12924 0 390072 0 0 THOMAS J LEGEL CHIEF FINANCIAL OFFICER (FROM 03/20) 0 348578 0 77 0 0 0 0 0 16071 0 364726 0 0 TRACEY A KASNIC CNO, HOSPITAL ADMIN - CWH 0 334721 0 31896 0 12805 0 20990 0 12118 0 412530 0 0 JEANINE M ALLEN SR VP CWH OUTP SVCS (THRU 06/20) 0 332854 0 32668 0 12733 0 20990 0 17803 0 417048 0 0 SARAH A BATTIS JOHNSON SR VP QUAL CARE TRNSFRMTN 0 217866 0 15068 0 15433 0 15109 0 12118 0 275594 0 0 JOELLEN COLSON SR VP ANCILLARY SERVICES 0 229373 0 21848 0 5992 0 15767 0 0 0 272980 0 0 JAY H JOHNSON SR VP NETWORK STRATEGY 0 218340 0 21193 0 4249 0 15441 0 12118 0 271341 0 0 STACI JONES SR VP SPECIALTY CARE 0 114861 0 22994 0 35208 0 15077 0 15960 0 204100 0 0 NICOLE M ANDERSON ARNP - OB-GYN 306108 0 7436 0 0 0 15510 0 26687 0 355741 0 0 0 MAUVIA A SORENSEN ARNP - BEHAVIORAL HEALTH 235249 0 5909 0 0 0 15057 0 21992 0 278207 0 0 0 MICHAEL D SIEG PHARMACY DIRECTOR 213148 0 21144 0 0 0 13711 0 26687 0 274690 0 0 0 AARON C LEWIS MD PHYSICIAN 239166 0 77 0 0 0 7175 0 0 0 246418 0 0 0 ANTHONY D CHAMBERS PA-C OCC MED 203075 0 5975 0 0 0 13766 0 13924 0 236740 0 0 0 JAMES B WOOD FORMER CHIEF ADMIN OFFICER 0 0 0 0 0 529269 0 0 0 0 0 529269 0 0 FARAZ S AHMED FORMER VP SR PRIMARY CARE 0 0 0 0 0 216297 0 0 0 0 0 216297 0 0 PART I, LINE 4A SEVERANCE PAYMENT TO FARAZ S. AHMED: $216,297 SEVERANCE PAYMENT TO JAMES B. WOOD: $529,269 PART I, LINE 6 EVERY PAY PERIOD, THE EMPLOYER CONTRIBUTES THE MATCH PERCENTAGE PER THE PLAN DOCUMENT INTO THE EMPLOYEES' RETIREMENT ACCOUNT. ANNUALLY, THE BOARD DETERMINES BASED ON FINANCIAL RESULTS IF AN ADDITIONAL (OR DISCRETIONARY) AMOUNT WILL BE CONTRIBUTED TO THE EMPLOYEES' ACCOUNTS. THE PERCENTAGE IS BASED ON EMPLOYEE CLASSIFICATION AND LENGTH OF SERVICE. THE DECISION IS BASED ON MEETING ORGANIZATIONAL GOALS, AND ONE OF THOSE GOALS IS THE COMBINED OPERATING MARGIN OF THE THREE CONFLUENCE HEALTH SYSTEM ORGANIZATIONS: CONFLUENCE HEALTH, CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, AND WENATCHEE VALLEY HOSPITAL. PART II: COMPENSATION FOR DR. STUART FREED AND DR. JASON LAKE IS REVIEWED, APPROVED, AND PAID BY AN UNRELATED THIRD PARTY, WENATCHEE VALLEY MEDICAL GROUP, FOR SERVICES PERFORMED FOR CONFLUENCE HEALTH. COMPENSATION PAID TO DR. STUART FREED IN 2020 WAS $425,907. COMPENSATION PAID TO DR. JASON LAKE IN 2020 WAS $608,719. FORM 990, PART III, LINE 3 THE COVID-19 PANDEMIC HAS HAD A SIGNIFICANT IMPACT ON RESULTS FOR THE YEAR ENDED DECEMBER 31, 2020. THE ORGANIZATION RECEIVED THE FIRST POSITIVE TEST RESULT ON MARCH 1, 2020. EFFECTIVE MARCH 17, 2020 THE ORGANIZATION BEGAN POSTPONING ALL ELECTIVE SURGERIES AND PROCEDURES BASED ON GUIDANCE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE STATE OF WASHINGTON DUE TO THE EMERGENCE OF COVID-19 WITHIN WASHINGTON STATE. THE STATE OF WASHINGTON ALSO PUT IN PLACE SOCIAL DISTANCING GUIDELINES AND A STATEWIDE STAY-AT-HOME ORDER ON MARCH 23, 2020; HOWEVER, THE ORGANIZATION IMPLEMENTED A WORK-FROM-HOME STRATEGY FOR OUR STAFF DURING MARCH 2020. ELECTIVE SURGERIES AND PROCEDURES RESUMED ON APPROXIMATELY MAY 18, 2020. AS THE COVID-19 PANDEMIC CONTINUES, THE ORGANIZATION HAS IMPLEMENTED COST CONTAINMENT STRATEGIES AND CONTINUES TO EXPLORE OPPORTUNITIES FOR COST CONTAINMENT. THE ORGANIZATION APPLIED FOR, AND RECEIVED, IN AVAILABLE GOVERNMENT ASSISTANCE THROUGH VARIOUS COMPONENTS OF THE CORONAVIRUS AID, RELIEF AND ECONOMIC SECURITY (CARES) ACT AND HAS SUBMITTED A PRELIMINARY REQUEST THROUGH THE FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA). COST CONTAINMENT STRATEGIES INCLUDED PARTICIPATING IN THE STATE OF WASHINGTON'S SHARED WORK PROGRAM, STRICT MANAGEMENT OF CONSULTING AND OTHER FORMS OF DISCRETIONARY SPENDING, RESTRICTIONS ON TRAVEL, RESTRICTING CAPITAL SPENDING FOR ONLY CRITICAL PROJECTS, FLEXING STAFFING LEVELS TO VOLUMES (IN ADDITION TO THE SHARED WORK PROGRAM) AND ENCOURAGING EMPLOYEES TO USE PAID TIME OFF. THE ORGANIZATION HAS RECEIVED, AS OF DECEMBER 31, 2020, $35,639,288 IN CARES ACT FUNDS AND AN ADDITIONAL $72,223,930 IN MEDICARE ADVANCE PAYMENTS. NO RESERVE HAS BEEN PLACED ON THE CARES ACT FUNDS WHILE THE MEDICARE ADVANCE PAYMENTS ARE RECORDED AS DEFERRED REVENUE. FINAL DETERMINATION OF NECESSARY RESERVES WERE MADE PRIOR TO THE FISCAL YEAR END YET MANAGEMENT BELIEVES ALL MONIES RECEIVED WILL ULTIMATELY BE SUPPORTED AND EARNED; GIVEN THE EVOLVING NATURE OF CARES ACT REQUIREMENTS. THE ORGANIZATION CONTINUES TO MONITOR AND ASSESS OTHER COVID-19 SUPPORT FUNDING OPPORTUNITIES AS THEY BECOME AVAILABLE. WITH VOLUMES RISING CLOSER TO NORMAL LEVELS TOWARDS YEAR END, FINANCIAL PROJECTIONS FOR THE LATTER HALF OF 2020 STABILIZED AND SHOWED BETTER THAN BREAK EVEN PERFORMANCE. WHILE THE VOLATILITY THAT SUBSEQUENT SURGES OF COVID-19, OR THE FLU SEASON, CANNOT BE KNOWN, IF THE PANDEMIC LEVELS REMAIN STABLE OR IMPROVE THE ORGANIZATION EXPECTS TO GENERATE AN OPERATING MARGIN BETWEEN 2.50% AND 3.00% FOR 2020 BASED ON CURRENT FINANCIAL MODELING, WHICH INCLUDES FUNDING RECEIVED FROM THE CARES ACT FUNDS. THE RANGE OF PERFORMANCE WILL BE AFFECTED BY THE NUMBER AND MAGNITUDE OF PATIENT SURGES, LIMITATION ON BED CAPACITY, ACCESS TO TESTING SUPPLIES, PPE REPLENISHMENT CHALLENGES AND EROSION IN NET PATIENT SERVICE REVENUE DUE TO SHIFTS IN PAYOR MIX CAUSED BY THE PANDEMIC. AMIDST THE ONGOING COVID-19 PANDEMIC MANAGEMENT IS FOCUSED ON ENSURING ITS FACILITIES AND TEAM REMAIN PREPARED TO MEET THE COMMUNITIES NEEDS. THE ORGANIZATION CONTINUES TO USE ITS DISASTER PLAN TO MANAGE ALL COVID-19 MATTERS AS WELL AS PLAN FOR A SURGE RELATED TO THE FLU SEASON. THE HOSPITAL INCIDENT COMMAND SYSTEM (HICS) TRIAGES MATTERS PERTAINING TO ITS PATIENTS, WORKFORCE, AND HEALTH CARE OPERATIONS AND ENSURES THAT FEDERAL AND STATE INFORMATION AND GUIDELINES ARE DISSEMINATED THROUGHOUT THE SYSTEM. THE HICS TEAM COORDINATES CLOSELY WITH THE LOCAL HEALTH DISTRICTS IN RESPONDING TO ADDITIONAL NEEDS IDENTIFIED BY THE HEALTH DISTRICTS IN THE COMMUNITIES SERVED. THE HICS TEAM IS ALSO RESPONSIBLE FOR ENSURING THE COORDINATION OF COVID-19 POLICIES, PROCEDURES, CLINICAL PRACTICES, STAFFING, LOGISTICS AND COMMUNICATIONS ACROSS THE SYSTEM ENABLING THE ORGANIZATION TO ACTIVELY MANAGE CURRENT PATIENT VOLUMES AND TO REMAIN PREPARED FOR SURGE NEEDS SHOULD THEY OCCUR. THE ORGANIZATION CANNOT PREDICT WHETHER THESE MEASURES WILL BE SUFFICIENT OVER THE LONG-TERM TO MITIGATE THE NEGATIVE EFFECTS OF THE COVID-19 PANDEMIC ON ITS FINANCES AND OPERATIONS. HOWEVER, THE ORGANIZATIONS MANAGEMENT TEAM WILL CONTINUE TO ASSESS AND IMPLEMENT INITIATIVES TO MANAGE COSTS AND ADJUST OPERATIONS TO KEEP ITS FACILITIES AND TEAMS SAFE AND EFFICIENT IN RESPONDING TO THE ONGOING CHANGES AS A RESULT OF THE COVID-19 PANDEMIC. FORM 990, PART VI, SECTION A, LINE 2 CONFLUENCE HEALTH AND AFFILIATES SHARE THE SAME BOARD AS PART OF THE OPERATING STRUCTURE. AS SUCH, ALL BOARD MEMBERS SERVE WITH EACH OTHER IN A SIMILAR CAPACITY ON RELATED ORGANIZATIONS. ADDITIONALLY, SOME BOARD MEMBERS ARE MINORITY OWNERS IN AN ENTITY THAT HAS A PROFESSIONAL SERVICE AGREEMENT WITH THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 WENATCHEE VALLEY HOSPITAL HAS A MANAGEMENT SERVICES ARRANGMENT WITH CONFLUENCE HEALTH, AN AFFILIATED ORGANIZATION EXEMPT UNDER SECTION 501(C)(3) AS A SUPPORTING ORGANIZATION. THIS AGREEMENT PROVIDES FOR SHARED USE OF FACILITIES, OFFICERS, EMPLOYEES, SUPPLIES AND OTHER ITEMS. THE COMPENSATION REPORTED IN PART VII AND PART IX IS PAID BY CONFLUENCE HEALTH UNDER THIS ARRANGEMENT. FORM 990, PART VI, SECTION A, LINE 4 THE FIDUCIARY STANDARD WAS UPDATED TO INCLUDE THAT THE ORGANIZATION ACTS AS PART OF THE HEALTH SYSTEM AND FOR THE COMMON PURPOSES OF THE HEALTH SYSTEM AS A WHOLE. THE CONFLICT OF INTEREST SECTION WAS UPDATED TO INCLUDE THAT DISCLOSURE SHALL REFLECT INFORMATION AS TO THE HEALTH SYSTEM AS A WHOLE. THE AMENDMENT PROCESS WAS UPDATED TO INCLUDE THAT ANY PROPOSED AMENDMENTS TO THE BYLAWS WILL NOW BE REVIEWED BY LEGAL COUNSEL PRIOR TO ADOPTION TO ENSURE CHANGES ARE CONSISTENT WITH APPLICABLE LAWS AND STANDARDS. THE COMPOSITION OF THE GOVERNING BODY WAS UPDATED TO REFLECT THE FOLLOWING CHANGE: - CHIEF OPERATING OFFICER WAS REPLACED WITH THE TITLE HOSPITAL ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 6 CONFLUENCE HEALTH, A NON-PROFIT CORPORATION ORGANIZED AND EXISTING PURSUANT TO CHAPTER 24.03 OF THE REVISED CODE OF WASHINGTON, WHICH IS KNOWN AS CONFLUENCE HEALTH AND IS THE PARENT ENTITY OF THE HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A UPON THE EXPIRATION OF THE TERM OF OFFICE OF ANY BOARD MEMBER, INCLUDING EACH OF THE INITIAL BOARD MEMBERS SET FORTH IN THE BYLAWS, THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH SHALL SELECT THE PERSON WHO SHALL FILL THE POSITION OF THE BOARD MEMBER WHOSE TERM IS EXPIRING, SUBJECT TO THE COMPOSITION REQUIREMENTS FOR THE BOARD OF DIRECTORS AS SET FORTH IN THE BYLAWS. THE PERSONS SELECTED BY THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH TO FILL THE POSITION OF THE BOARD MEMBER WHOSE TERM IS EXPIRING SHALL BE OF THE HIGHEST COMPETENCE AND QUALITY WHO ARE WITHOUT CONFLICTS WITH WENATCHEE VALLEY HOSPITAL THAT WOULD PROHIBIT THEIR SERVING IN ACCORDANCE WITH THE BYLAWS AND TAX OR OTHER REGULATORY REQUIREMENTS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 AND SCHEDULE B, IF ANY, IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF FINANCE. SUBSEQUENT TO THIS REVIEW THE FORM 990 AND SCHEDULE B IS REVIEWED BY THE GOVERNING BOARD BEFORE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS, EXECUTIVE TEAM MEMBERS, AND DIRECTORS ARE REQUIRED TO REVIEW THE CURRENT CONFLICT OF INTEREST POLICY AND COMPLETE AN ANNUAL QUESTIONNAIRE. THE NOMINATING COMMITTEE OF THE BOARD REVIEWS QUESTIONNAIRES OF EXISTING AND NEW MEMBERS FOR POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS OF INTEREST ARE RESOLVED BY THE NOMINATING COMMITTEE. THE EXECUTIVE TEAM REVIEWS QUESTIONNAIRES SUBMITTED BY EXECUTIVE TEAM MEMBERS AND DIRECTORS FOR POTENTIAL CONFLICTS OF INTEREST. POTENTIAL CONFLICTS OF INTEREST ARE RESOLVED BY THE EXECUTIVE TEAM IN COLLABORATION WITH THE CORPORATE COMPLIANCE OFFICER. REVIEW OF ALL CONFLICT OF INTEREST STATEMENTS IS NOTED WITHIN THE BOARD MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD ANNUALLY REVIEWS INDEPENDENT SALARY SURVEY INFORMATION AND RECOMMENDS A SALARY AND/OR A SALARY INCREASE FOR THE CEO TO THE GOVERNING BOARD. THE OTHER OFFICERS RECEIVE AN ANNUAL PERCENT INCREASE WHICH NON-CONTRACTUAL EMPLOYEES RECEIVE UNLESS THE CEO AWARDS A DIFFERENT PERCENTAGE. THE AMOUNT IS, TYPICALLY, BASED ON CURRENT CPI, MARKET AND SALARY SURVEY INFORMATION. FORM 990, PART VI, SECTION C, LINE 19 WENATCHEE VALLEY HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CUMULATIVE EFFECT OF ACCOUNTING CHANGE -5,158,411. FORM 990, PART XII, LINE 3B: WENATCHEE VALLEY HOSPITAL IS IN THE PROCESS OF COMPLETING THE REQUIRED A-133 AUDIT FOR THE YEAR ENDED DECEMBER 31, 2020. THE EXTENDED DUE DATE FOR COMPLETION IS MARCH 31, 2022. 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