2021-08-16T11:33:53-05:00 2020-09-30 930623286 Aldrich CPAs and Advisors LLP 5665 SW Meadows Rd Suite 200 Lake Oswego OR 97035 990 2019-10-01 930223960 ASANTE ASAN 5417894103 2650 SISKIYOU BLVD MEDFORD OR 97504 Greg Wojtal CAFO 5417894103 2021-08-11 Joylyn M Ankeney CPA P00366587 5036204489 2021-08-11 2019 2022-09-23 18:48:47Z Greg Wojtal 2650 SISKIYOU BLVD MEDFORD OR 97504 1561992714 0 X www.asante.org X 1938 OR Asante exists to provide quality healthcare services in a compassionate manner, valued by the communities we serve. 12 11 6149 11 3064044 0 1336150 1044492 881021570 900575807 33472065 25330238 9596 1646191 915839381 928596728 457850 208994 0 0 441804380 479090521 0 0 0 369397474 378091394 811659704 857390909 104179677 71205819 1358654000 1867375413 380564755 814486199 978089245 1052889214 X Asante exists to provide quality healthcare services in a compassionate manner, valued by the communities we serve. 0 0 407701087 626997815 Asante's main program service accomplishment is the operation of Asante Rogue Regional Medical Center (ARRMC), a 378 licensed bed hospital located in Medford, Oregon. ARRMC was named the 3rd best hospital in Oregon by US News & World Report. In additon they were named one of the top 50 cardiovascular hospitals in the nathion. They also received a 5-star rating from CMS. The hospital also earned the Patient Safety Excellence, Pulmonary Care Excellence and Joint Replacement Excellence Awards from Healthgrades. Healthgrades also named ARRMC as one of the 100 best in America for spine surgery and one of the 50 best for vascular surgery. The American Heart Association awarded ARRMC with the Gold Plus for STEMI Receiving Center. Key hospital inpatient services include Cancer Services, Cardiovascular Surgery, and inpatient Cardiac Catherization Laboratory, General Medicine, General Surgery, Gynecology, Neonatology, Neurosciences, Obstetrics, Orthopedics, Pediatrics, and Urology Services. Other inpatient services include Behavioral Health, Rehabilitation, and critical care services, including the region's only Level 3 Neonatal Intensive Care Unit. Key outpatient services include Emergency Services, Ambulatory Surgery, Outpatient Laboratory testing and diagnosis, outpatient Cardiac Catherization Lab, Imaging, Sleep Services, Hospice, and various therapies, including behavioral, occupational, physical, and speech.During fiscal year 2020, RRMC admitted 15,692 patients for a total of 91,301 patient days. It also had over 444,000 total outpatient visits and delivered 1,684 babies. The Emergency Rooms treated 45,962 patients and the Chemistry Labs performed over 2.2 million tests. Surgical services performed 9,799 inpatient and outpatient surgeries at RRMC. Other statistics at RRMC include 23,607 hospice visits, 84,882 visits to the various Rehab units, and over 134,000 visits to Imaging. 124278569 182297922 Asante's second largest program service accomplishment by expense is the operation of Asante Three Rivers Medical Center (ATRMC), a 125 licensed bed hospital located in Grants Pass, Oregon. ATRMC received a Grade "A" Hospital Safety Score from Leapfrog for the fifth consecutive year. They were named the 9th best hospital in Oregon by US News & World Report. Health Grades named them one of the 100 best hospitals in America for joint replacement. Additionally, ATRMC received a 5-star rating from CMS.Some of the key inpatient services available at TRMC include cancer services, general medicine, general surgery, gynecology, obstetrics, orthopedics, and pediatrics. Some of the key outpatient services include emergency services, ambulatory surgery, outpatient lab testing, cardiopulmonary services, outpatient cardiac catherization lab, imaging and various therapies including physical, occupational, and speech.During the fiscal year, TRMC admitted 6,555 inpatients for a total of 23,533 patient days. They also delivered 677 babies and had over 235,000 outpatient visits. The chemistry lab performed nearly 570,000 tests and the emergency room saw 38,579 patients. There were 6,171 surgeries performed during the year. TRMC's rehab department had 29,432 visits and the various imaging departments had over 80,000 visits. 44570834 208994 89943127 Asante's third largest program service accomplishments by expense are the operation of Asante Ashland Community Hospital, a 49 licensed bed hospital located in Ashland, Oregon and the operation of the Corporate division. AACH also received a 5-star rating form CMS. Asante Health System was named one of the "15 Top Health Systems in the Nation" for the ninth year in a row by Truven Health Analytics. CareChex named Asante the 3rd overall hospital in the nation for overall care. In addition, Asante was named Best in State Employer by Forbes. Key inpatient serices available at ACH include general medicine, general surgery, gynecology and obstetrics. Some the key outpatient services include emergency services, ambulatory surgery, outpatient lab testing, imaging and various therapies.During the fiscal year, ACH admitted 1,061 inpatients for a total of 4,167 patient days. They delivered 209 babies and had over over 38,000 outpatient visits. The lab performed over 140,000 tests, the emergency room saw 8,756 patients and, there were 2,065 surgeries performed during the year. Asante's corporate division has made generous cash donations to numerous non-profit organizations. These donations help support a variety of local programs, such as The Maslow Project which provides resources to homeless youth to the annual Pear Blossom Festival to encourage health through movement. Other notable donations include local foodbanks, sexual assault response teams, suicide prevention and youth camps. Often, indigent and Medicaid patients will show up at the Emergency Room in need of specialized medical care. In order to assure that unassigned indigent and Medicaid patients have specialized care available to them, Asante created Southern Oregon Trauma and Emergency Services (SOTES). SOTES contracts with local independent physicians to provide specialized care to these patients throughout their hospital stay. The physician bills SOTES, which will reimburse the specialist at Medicare rates. SOTES operates at breakeven. Expenses are fully funded and reimbursed to the doctor by the hospitals. 576550490 1 1 0 1 0 0 0 0 0 1 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 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 549 0 1 6149 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X X Greg Wojtal 5417894549 2650 Siskiyou Blvd Medford OR 97504 Scott Kelly President & CEO 40.00 X 1050970 0 31490 Greg Wojtal CAFO 40.00 X 672927 0 37948 Mick Zdeblick RRMC CEO 40.00 X 633293 0 40753 James Grebosky Chief Qual&Safe Officer 40.00 X 597076 0 45164 Lee Milligan MD Chf Info Officer 40.00 X 561920 0 42385 Win Howard TRMC CEO 40.00 X 537449 0 47899 Roy Vinyard Former President&CEO-term 1/5/19 40.00 X 512045 0 47816 Paul Macuga Chief People Officer 40.00 X 482553 0 15535 Dennie Conrad Chief Strategy Officer 40.00 X 474964 0 39850 Michael McCaskill Medical Doctor 40.00 X 469226 0 34531 Eric Loeliger MD VP Medical Affairs - TR 40.00 X 425705 0 46892 Sheila Clough ACH CEO 40.00 X 425648 0 43239 Courtney Wilson MD Medical Doctor 40.00 X 424977 0 16800 Kristen Roy VP Legal Office 40.00 X 392548 0 29439 Chris David MD Medical Doctor 40.00 X 386550 0 46664 Mark Hetz Ch Info Officer 40.00 X 380820 0 9053 Janet Eoff MD Medical Doctor 40.00 X 377450 0 40776 Douglass Schmor Chairperson 2.00 X X 0 0 0 Peter Angstadt PhD Vice Chairperson 2.00 X X 0 0 0 Ken Trautman Treasurer 2.00 X X 0 0 0 Patricia Wintemute Secretary 2.00 X X 0 0 0 Stephen D Roe Trustee 2.00 X 0 0 0 Ray A Cox Trustee 2.00 X 0 0 0 Anne Golden Trustee 2.00 X 0 0 0 Thomas M Turek MD Trustee 2.00 X 0 0 0 Sandra Slattery Trustee 2.00 X 0 0 0 Stephen Gambee Trustee 2.00 X 0 0 0 Brian Gross MD Trustee 2.00 X 0 0 0 8806121 0 616234 801 1 1 0 Focusone Solutions LLC 13609 California St Ste 420 Omaha NE 68154 Management Services 15198482 Southern Oregon Hospitalists 2640 E Barnett Rd Medford OR 97504 Physician Services 5862092 Hematology Oncology Associates 2828 E Barnett Rd Medford OR 97504 Oncology Services 5051953 Anesthesia Associates of Medford 842 E Main St Medford OR 97504 Physician Services 4163008 Southern Oregon Cardiology LLC 520 Medical Center Drive Suite 200 Medford OR 97504 Cardiac Services 2674780 15 994492 50000 1044492 Hospital Services 622110 853781272 852444329 1336943 Other Operating Income 900099 41126361 41126361 Nutrition Services 621990 3938011 3938011 JV Income 621990 1730163 1730163 900575807 19918140 19918140 2239369 2320279 -80910 -80910 -80910 626373810 2997866 619785748 4173830 6588062 -1175964 5412098 5412098 8843230 7116129 1727101 1727101 928596728 899238864 3064044 25249328 208994 208994 4533559 4533559 356198183 258874756 97323427 16344221 11766234 4577987 77113142 51489102 25624040 24901416 18080278 6821138 2985360 2985360 279345 279345 108769 108769 1658354 1658354 12537479 1749518 10787961 11183 11183 3040793 861449 2179344 21961298 9581342 12379956 974558 461958 512600 8180760 8180760 46449672 52755 46396917 829741 829741 Patient Supplies 178183514 172184548 5998966 Purchased Services 53080922 27767034 25313888 Bad Debts 21129013 21128975 38 Other Operating Expense 16228462 2343547 13884915 10452171 10452171 857390909 576550490 280840419 0 65542046 169197036 116960014 110447687 21429646 18953285 15939104 17852355 12216038 14249891 839414898 474647079 327018025 364767819 637411766 672373519 162137361 499533821 1358654000 1867375413 16523911 26125884 230574468 543943580 521329 6549000 132945047 237867735 380564755 814486199 X 978089245 1052889214 978089245 1052889214 1358654000 1867375413 X 71205819 3455747 138403 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 54769 0 0 1 54000 108769 0 Part II-B, Line 1: Asante maintains memberships in the American Hospital Assoc (AHA) and Oregon Assoc of Hospitals and Healthcare Systems (OAHHS). During tax year 2019, Asante paid membership dues to the AHA and OAHHS of $90,687 and $241,899 respectively. 14.12% of OAHHS dues and 22.73% of AHA dues went for lobbying purposes. Thus, Asante made indirect lobbying expenditures of $54,769 through its membership dues. Also, Asante paid John Watt and Associates (JWA) $54,000 for specific issues lobbying during the tax year. JWA is an advocate for Asante and specializes in ballot propositions affecting the healthcare industry. 24115278 2245042 716219 134066 26942473 21832879 239166 2197771 154538 24115278 21035987 96879 1118497 418484 21832879 19768780 1025379 712656 470828 21035987 19809910 65967 149912 257009 19768780 0.76160 0.23160 0.00680 0 1 1 10809422 20580871 31390293 386691952 210351431 176340521 25718134 6205876 19512258 340603561 258089772 82513789 55010958 55010958 364767819 Invest in Healthcare Ventures 5715598 Intercompany Receivables 165057159 Other Assets 328761064 499533821 Current Portion Self Insurance Reserve 8221527 Reimbursement Due Govt Agencies & 3rd Parties 11797522 Other Current Liabilities 93627515 Long Term Liabilities 34865819 Payroll/Benefits Payable 52454488 Current portion LT Debt 15347704 Long Term Self Insurance Reserve 21553160 237867735 X 982990093 3455747 73724947 77180694 905809399 1658354 21128975 22787329 928596728 943566544 108962964 108962964 834603580 1658354 21128975 22787329 857390909 Part V, Line 4: The Asante Foundation, a 501(c)(3) organization, is directly related to and controlled by Asante. It is identified on Schedule R, Part II as a related tax-exempt organization. The Asante Foundation maintains the assets of 15 different endowments with a net worth of over $26.0 million. The corpus of the endowments is to remain intact and invested in marketable securities and other financial instruments. At the end of each fiscal year, any investment income generated from the endowments is released to Asante. The income received is used to subsidize numerous programs, including the RRMC Hospice, physician and nursing education, children's health, oncology programs, and support of the Francis Cheney and Three Rivers Family Houses. Part X, Line 2: Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by Asante and recognize a tax liability (or asset) if Asante has taken an uncertain tax position that more likely than not would not be sustained upon examination by the IRS. Management has analyzed tax positions taken by Asante and has concluded that as of September 30, 2020, there are no uncertain positions taken, or expected to be taken, that would require recognition of a liability (or an asset) or disclosure in the consolidated financial statements. Part XI, Line 2d - Other Adjustments: Operating Income from affiliates included in consolidated financial stmt 72,584,149. Affiliate Investment Revenue included in consolidated financial stmt 1,140,798. Part XI, Line 4b - Other Adjustments: Bad Debt Expense Netted with Revenue on financial stmt 21,128,975. Part XII, Line 2d - Other Adjustments: Affiliate Operating Expenses included in consolidated financial stmt 105,282,384. Unrealized Gain 3,680,580. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 21,128,975. Schedule D Part XI, XII and XIII The financial statements and schedules of Asante are audited by the accounting firm of KPMG. They are compiled on a consolidated basis. The consolidated financial statements and schedules contain financial information about entities within Asante that are not included on the Asante form 990. Financial information about the Asante Foundation, Asante Physicians Partners, Southern Oregon Insurance Company, and Asante Ashland Community Hospital are included in the audited consolidated financial statements but, since each of those entities retain their own tax identification number, they file their own separate form 990. Thus, their financial information is excluded from the Asante form 990 and are included as reconciling items on Schedule D. On the Asante form 990, Schedule D, Parts XI, XII, and XIII, we have reconciled the total revenues, total expenses, and net assets to the consolidated statement of operations on the audited financial statements. In many cases, the financial information of these other entities is contained within the revenue, expenses, and net assets items in the financial statement and may not be readily distinguished on the financial statement line items. 1 1 X 1 X 1 X 1 1 0 1 1 73310 9286310 2054733 7231577 0.00860 132264 204443791 150245917 54197874 0.06480 19973 42077742 35025262 7052480 0.00840 225547 255807843 187325912 68481931 0.08180 11705 12875605 348904 12526701 0.01500 1935631 19125 1916506 0.00230 20662287 10878761 9783526 0.01170 0 0 418139 11753 406386 0.00050 11705 35891662 11258543 24633119 0.02950 237252 291699505 198584455 93115050 0.11130 320 20882 20882 0.00000 37 3906 3906 0.00000 357 24788 24788 0.00000 1 21128438 2873468 218460270 275547501 -57087231 X 1 1 2 CVI Management Co LLC Management Services 0.25000 0.75000 3 CVI Real Property Property Management 0.25000 0.75000 4 Southern Oregon Linen Svcs Linen Processing 0.43000 5 Health Future LLC Supplies Purchasing 0.25000 6 Surgery Center of So Oregon Outpatient Surgeries 0.20000 0.80000 7 LHC Home health 0.25000 8 Accentcare Home health 0.25000 9 Women's Center Women's Imaging 0.50000 10 2859 State St LLC Real Estate 0.50000 3 1 Rogue Regional Medical Center 2825 E Barnett Road Medford OR 97504 www.asante.org 14-0451 X X X 2 Three Rivers Medical Center 500 SW Ramsey Ave Grants Pass OR 97527 www.asante.org 14-1439 X X X 3 Ashland Community Hospital 280 Maple St Ashland OR 97520 www.asante.org 14-1445 X X X Rogue Regional Medical Center 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X https://www.asante.org/app/files/public/3212/arrmc-chna-cha-2019-final.pdf X 1 18 1 https://www.asante.org/app/files/public/3238/arrmc-2019-chip-07-26-19.pdf 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X X X X X X 1 0 X X X X 1 X 0 0 Three Rivers Medical Center 2 0 0 1 X X X X X X X X X 18 1 1 1 1 X https://www.asante.org/app/files/public/3214/atrmc-chna-cha-2019-final.pdf X 1 18 1 https://www.asante.org/app/files/public/3239/atrmc-2019-chip-07-26-19.pdf 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X X X X X X 1 0 X X X X 1 X 0 0 Ashland Community Hospital 3 0 0 1 X X X X X X X X X 18 1 1 1 1 X https://www.asante.org/app/files/public/3210/aach-chna-cha-2019-final.pdf X 1 18 1 https://www.asante.org/app/files/public/3237/aach-2019-chip-07-26-19.pdf 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X http://www.asante.org/patients-visitors/billing-and-financial-assistance/ X X X X X X 1 0 X X X X 1 X 0 0 Rogue Regional Medical Center Part V, Section B, Line 5: As part of the Patient Protection and Affordable Care Act's requirement to conduct a community health needs assessment every three years, Asante, Rogue Regional Medical Center, Ashland community Hospital, and Three Rivers Medical Center partnered with Professional Research Consultants, Inc. to complete 600 community surveys in tax year 2018. That year, we also held a focus group comprised of 13 key community leaders from Jackson and Josephine Counties. The focus group discussed the individual leaders' experiences and perceptions of the top health concerns in our community. Three Rivers Medical Center Part V, Section B, Line 5: As part of the Patient Protection and Affordable Care Act's requirement to conduct a community health needs assessment every three years, Asante, Rogue Regional Medical Center, Ashland community Hospital, and Three Rivers Medical Center partnered with PRC to complete 600 community surveys in tax year 2018. That year, we also held a focus group comprised of 7 key community leaders from Jackson and Josephine Counties. The focus group discussed the individual leaders' experiences and perceptions of the top health concerns in our community. Ashland Community Hospital Part V, Section B, Line 5: As part of the Patient Protection and Affordable Care Act's requirement to conduct a community health needs assessment every three years, Asante, Rogue Regional Medical Center, Ashland community Hospital, and Three Rivers Medical Center partnered with PRC to complete 600 community surveys in tax year 2018. That year, we also held a focus group comprised of 7 key community leaders from Jackson and Josephine Counties. The focus group discussed the individual leaders' experiences and perceptions of the top health concerns in our community. Rogue Regional Medical Center Part V, Section B, Line 6a: Asante Ashland Community Hospital in Ashland, OregonThree Rivers Medical Center in Grants Pass, Oregon Three Rivers Medical Center Part V, Section B, Line 6a: Asante Ashland Community Hospital in Ashland, OregonRogue Regional Medical Center in Medford, Oregon Ashland Community Hospital Part V, Section B, Line 6a: Rogue Regional Medical Center in Medford, OregonThree Rivers Medical Center in Grants Pass, Oregon Rogue Regional Medical Center Part V, Section B, Line 6b: The CHNA was conducted with the following organizations which are not hospital facilities:ACCESSAddictions Recovery Center (ARC)CASA of Jackson CountyChildren's Advocacy Center ofJackson CountyFood & Friends Rogue ValleyCouncil of GovernmentsFormer Jackson CountyCommissionerHearts With a MissionJefferson Regional Health AllianceJWA Public AffairsNorth Medford High SchoolRogue Valley Family YMCAUnited Way of Jackson County Three Rivers Medical Center Part V, Section B, Line 6b: The CHNA was conducted with the following organizations which are not hospital facilities:ACCESSAddictions Recovery Center (ARC)CASA of Jackson CountyChildren's Advocacy Center ofJackson CountyFood & Friends Rogue ValleyCouncil of GovernmentsFormer Jackson CountyCommissionerHearts With a MissionJefferson Regional Health AllianceJWA Public AffairsNorth Medford High SchoolRogue Valley Family YMCAUnited Way of Jackson County Ashland Community Hospital Part V, Section B, Line 6b: The CHNA was conducted with the following organizations which are not hospital facilities:ACCESSAddictions Recovery Center (ARC)CASA of Jackson CountyChildren's Advocacy Center ofJackson CountyFood & Friends Rogue ValleyCouncil of GovernmentsFormer Jackson CountyCommissionerHearts With a MissionJefferson Regional Health AllianceJWA Public AffairsNorth Medford High SchoolRogue Valley Family YMCAUnited Way of Jackson County Rogue Regional Medical Center Part V, Section B, Line 11: Identified Health Needs The top five health needs identified by both survey and focus group participants are:1. Access to health care services 2. Mental health3. Substance abuse 3. Heart disease and stroke 4. Infant health and family planning Implementation StrategyThe top 3 (due to space limitations) initiatives and actions below as they relate to the top 5 community health needs categories as identified in the CHNA will be fulfilled or implemented by: Asante Rogue Regional Medical Center (ARRMC) 1.) Access to health care services Three Rivers Medical Center Part V, Section B, Line 11: Identified Health Needs The top five health needs identified by both survey and focus group participants are:1. Access to health care services 2. Mental health3. Substance abuse 3. Heart disease and stroke 4. Infant health and family planning Implementation StrategyThe top (due to space limitations) initiatives and actions below as they relate to the top 5 community health needs categories as identified in the CHNA will be fulfilled or implemented by: Asante Three Rivers Medical Center (ATRMC) 1.) Access to health care services Ashland Community Hospital Part V, Section B, Line 11: Identified Health Needs The top five health needs identified by both survey and focus group participants are:1. Access to health care services 2. Mental health3. Substance abuse 3. Heart disease and stroke 4. Infant health and family planning Implementation StrategyThe top (due to space limitations) initiatives and actions below as they relate to the top 5 community health needs categories as identified in the CHNA will be fulfilled or implemented by: Asante Ashland Community Hospital (AACH)1.) Access to health care services Rogue Regional Medical Center Part V, Section B, Line 16j: Partial information, but not the entire policy, about applying for financial aid is printed on the patient's billing statement. The entire financial assistance policy is posted on the Asante website at www.asante.org. The entire policy is also on posters in the Patient Registration department. If a patient wishes to apply for financial aid, they are directed to call the hospital for a financial assistance application. Three Rivers Medical Center Part V, Section B, Line 16j: Partial information, but not the entire policy, about applying for financial aid is printed on the patient's billing statement. The entire financial assistance policy is posted on the Asante website at www.asante.org. The entire policy is also on posters in the Patient Registration department. If a patient wishes to apply for financial aid, they are directed to call the hospital for a financial assistance application. Ashland Community Hospital Part V, Section B, Line 16j: Partial information, but not the entire policy, about applying for financial aid is printed on the patient's billing statement. The entire financial assistance policy is posted on the Asante website at www.asante.org. The entire policy is also on posters in the Patient Registration department. If a patient wishes to apply for financial aid, they are directed to call the hospital for a financial assistance application. Rogue Regional Medical Center Part V, Section B, Line 18e: Rogue Regional Medical Center's "Policy" is to allow third parties to perform lawsuits, place liens on residences, and garnish wages, but only as a final resort. However, the Asante business office is authorized to place a voluntary lien on a patients residence on certain rare circumstances. The patient must approve the voluntary lien first. Three Rivers Medical Center Part V, Section B, Line 18e: Three Rivers Medical Center's "Policy" is to allow third parties to perform lawsuits, place liens on residences, and garnish wages, but only as a final resort. However, the Asante business office is authorized to place a voluntary lien on a patients residence on certain rare circumstances. The patient must approve the voluntary lien first. Ashland Community Hospital Part V, Section B, Line 18e: Rogue Regional Medical Center's "Policy" is to allow third parties to perform lawsuits, place liens on residences, and garnish wages, but only as a final resort. However, the Asante business office is authorized to place a voluntary lien on a patients residence on certain rare circumstances. The patient must approve the voluntary lien first. Rogue Regional Medical Center Part V, Section B, Line 20e: Notify individuals of FAP prior to discharge Three Rivers Medical Center Part V, Section B, Line 20e: Notify individuals of FAP prior to discharge Ashland Community Hospital Part V, Section B, Line 20e: Notify individuals of FAP prior to discharge 1 1 - Rogue Valley RX 2900 E Barnett Road Medford OR 97504 Outpatient Pharmacy Part I, Line 7: Cost to Charge Ratio is used to calculate benefit expenses. Part I, Line 7g: Subsidized services include Behavioral Health, Emergency Services which includes Southern Oregon Trauma and Emergency Services (SOTES) and Disaster Emergency (COVID-19) departments. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 21,128,438. Part II, Community Building Activities: In fiscal 2020, Asante's contribution to Community Health Improvements Advocacy includes $24,788 split between monetary donations and staff support for Emergency Preparedness and Disaster Readiness drills and education to the community. Part III, Line 2: Cost to Charge Ratio Part III, Line 3: Percentage of the population that would qualify for Charity Care according to poverty rate from Census Bureau, 13.6% poverty rate in 2020, that percentage of bad debt is assumed to be part of missed Charity Care. Part III, Line 4: Bad debt expense is reported based on gross patient charges that have been written off due to non-payment. Part III, Line 8: Certain government sponsored health insurance companies, such as Medicare and Medicaid, pay a significantly reduced amount for medical services rendered to their insurees. Oregon law in ORS 442.200(2) considers the difference between the expenses and reimbursement with respect to Medicare and Medicaid patients to be community benefit. Calculation: Total Medicare payments per cost report less total Medicare costs per cost report = Unrecovered Medicare cost per cost report. Part III, Line 9b: If there is an indication that a patient may be unable to pay their bill, a financial questionnaire is given or sent to the patient. On receipt of the completed questionnaire, the business office will determine eligibility for financial assistance and notify the patient within 20 days. Eligibility is determined based upon the questionnaire and on financial documents, such as tax returns, SSI statements, paycheck stubs, and FSA/HSA information. The patient's other financial obligations, number of dependents, assets and other financial circumstances are considered. Often, a patient will not provide a financial questionnaire, so the business office will use soft credit checks and zip codes+4 to help determine eligibility. The percentage of financial assistance provided is based upon a sliding scale table that utilizes the patient family's income as a percentage of the Federal Poverty Guidelines. Part III, Section B Unreimbursed Costs from the Medicare Program (using the Medicare Cost Report). Part VI, Line 2: Asante's five primary sources of input include the Community Leaders Forum, the environmental assessment, the community assessment survey, formal conversations with our collaborators, and identified Strategic Plan gaps from the previous year. Part VI, Line 3: The Financial Access Specialists, Credit Analysts, and Registration personnel work with the patient either at the time of scheduling, arrival at the hospital, or during the billing process. If the patient discloses they will have difficulty paying, we assist them applying for the Oregon Health Plan, Financial Assistance, or a payment plan. Based upon income and expenses, a patient may be eligible for Charity Care write-off of between 10% and 100% of their bill. Part VI, Line 4: The most notable fact about the demographics of our service area is that we have a rather elderly population, both in our primary service area of Jackson and Josephine Counties, but also our secondary service area of northern California and southern Oregon. In fiscal 2020, patients 65+ accounted for 54.08 %52.74% and 53.78% of admissions at ACH, RRMC and TRMC respectively.For the next 20 years, the 65+ age group is forecast to be the fastest growing segment of the population. In addition, the overall population growth of our primary service area is also forecast to average 1% per year for the next 30 years. Part VI, Line 5: Along with providing quality healthcare, Asante furthers its exempt purpose and fulfills its mission to the community by providing or subsidizing numerous classes, support groups, health fairs, and self-help programs. These programs are at no or low cost to the public. The Asante Community Health Education Program is an ongoing, no cost program, open to all community members. In FY 2020, over 15 community health education classes were offered at RRMC and TRMC. On average, attendance well exceeded 75 people at each event. Asante also promotes and extends patient care by providing space and materials to approximately 30 support groups. Asante Hospice, RVMC and TRMC Cancer services, and RVMC/TRMC Women and Children's Services provide staff, resources and organizational support for various well-attended support groups and dedicational events, such as "Cancer Survivor's Day". Many other support groups are community-led, but logistically supported by Asante Health System and affiliated clinical staff members. The Smullin Health Education Center houses community and healthcare related events. Along with the Asante Community Health Education Program and support groups, Smullin hosted over 125 events. Operationally, Asante Health System supports these events by providing salaries, benefits, supplies and classroom space. Additionally, Asante is the sole support of the Francis Cheney Family Place and the Three Rivers Family House. Much like the Ronald McDonald House, these Houses provide low-cost temporary lodging for families of patients at RVMC or TRMC. Donations are accepted, but no one is denied lodging for an inability to contribute.Asante Health System has several clinical departments that provide non-billed services to community members. These departments include the Sterile Processing Department, Imaging Department, RRMC/TRMC pharmacies (both hospital and retail), Social Services, Resource Management, Senior Transportation, and the Supportive Care Team. RRMC also provides free lab work to the patients of the Community Health Centers. The Asante Health System strives to meet their on-going mission: Asante exists to provide quality healthcare services in a compassionate manner, valued by the communities we serve. Part VI, Line 6: Asante is a community owned and governed not-for-profit health system providing comprehensive healthcare services to more than 550,000 residents in nine counties throughout southern Oregon and northern California. The System was formed in 1995 to include Rogue Regional Medical Center (RRMC) in Medford, and Three Rivers Medical Center (TRMC) in Grants Pass. In 2013, Ashland Community Hospital (ACH) in Ashland was aquired to better serve Jackson county. Part VI, Line 7, Reports Filed With States OR 1 Jackson County SART 2305 Ashland St Ashland OR 97520 810650183 501(c)(3) 45000 Cash Funds are dedicated to the support of the training and provision of SANE nurses within in Jackson County. Pear Blossom Run PO Box 335 Medford OR 97501 475622033 501(c)(3) 15000 Cash Provide access to YMCA programs for community members would otherwise not have access due to physical limitation, financial or geographical constraints. Access Food Bank 3630 Aviation Way Medford OR 97504 930665396 501(c)(3) 20000 Cash Support ACCESS nutrition programs serving Jackson County's low income families and individuals, seniors and people with disabilities. Oregon Business Council Charitable Institute 1100 SW 6th Ave Ste 1608 Portland OR 97204 931240928 501(c)(3) 36094 Cash Blue Zone Project - The focus of this project is to improve the quality of life and health of community members through a number of initiatives and community programs addressing nutrition, social and emotional well-being and connection, physical activity and community. Josephine County Food Bank PO Box 250 Grants Pass OR 97528 471904505 501(c)(3) 20000 Cash Support nutrition programs serving Josephine County's low and no income families and individuals, seniors and people with disabilities. Addictions Recovery Center 1003 E MAIN ST STE 104 Medford OR 97504 930645605 501(c)(3) 10000 cash Addictions Recvoery Center provides assistance and support to those in addiction recovery programs. 6 Part I, Line 2: Once an applicant has been approved for grant funds, the grant agreement specifies that all grant monies are to be spent for only the purpose spelled out in the application. The County Connections Committee must know where the donated money will be allocated, and if a fundraising event, how the raised money will be allocated. Usually, a detailed budget of the grantee's current year is required, as well as any reports or minutes from previous events. Schedule I, Part I, Line 2 When Asante receives a request for grant funds from an outside organization, the request is reviewed by either the Jackson County or Josephine County Community Connections Committee. The applicant must fill out an application form and provide supporting documents or event materials. To be selected, the organization must meet the following criteria: 1)the grant must support strategic initiatives, 2)it must have a direct impact on the healthcare of the community, 3)the organization must be a not-for-profit health, human services, or education related organization, 4)the organization collaborates with other not-for-profit organizations and, 5)the grant must be a relation building opportunity. 1 X X X X X 1 1 0 0 0 0 0 0 0 Scott Kelly President & CEO 848206 0 202033 0 731 0 16800 0 14690 0 1082460 0 0 0 Greg Wojtal CAFO 517632 0 113603 0 41692 0 16800 0 21148 0 710875 0 0 0 Mick Zdeblick RRMC CEO 503475 0 110818 0 19000 0 16800 0 23953 0 674046 0 0 0 James Grebosky Chief Qual&Safe Officer 471328 0 106748 0 19000 0 16800 0 28364 0 642240 0 0 0 Lee Milligan MD Chf Info Officer 451660 0 91260 0 19000 0 16800 0 25585 0 604305 0 0 0 Win Howard TRMC CEO 422662 0 95787 0 19000 0 16800 0 31099 0 585348 0 0 0 Roy Vinyard Former President&CEO-term 1/5/19 229871 0 282174 0 0 0 16800 0 31016 0 559861 0 0 0 Paul Macuga Chief People Officer 85935 0 69434 0 327184 0 9405 0 6130 0 498088 0 0 0 Dennie Conrad Chief Strategy Officer 356597 0 83786 0 34581 0 16800 0 23050 0 514814 0 0 0 Michael McCaskill Medical Doctor 448526 0 20700 0 0 0 16800 0 17731 0 503757 0 0 0 Eric Loeliger MD VP Medical Affairs - TR 359219 0 47486 0 19000 0 16800 0 30092 0 472597 0 0 0 Sheila Clough ACH CEO 330471 0 76177 0 19000 0 16800 0 26439 0 468887 0 0 0 Courtney Wilson MD Medical Doctor 399622 0 25355 0 0 0 16800 0 29454 0 471231 0 0 0 Kristen Roy VP Legal Office 324515 0 49033 0 19000 0 16800 0 12639 0 421987 0 0 0 Chris David MD Medical Doctor 378167 0 8383 0 0 0 16800 0 29864 0 433214 0 0 0 Mark Hetz Ch Info Officer 50549 0 74929 0 255342 0 6449 0 2604 0 389873 0 0 0 Janet Eoff MD Medical Doctor 363150 0 14300 0 0 0 16800 0 23976 0 418226 0 0 0 Part I, Line 3 The salary range of the executive staff is set by the Asante Compensation committee and is approved by the Asante Board of Directors on an annual basis. However, Roy Vinyard, the CEO/Executive Director of Asante has his salary determined by independant compensation consultants, written employment contracts, and a compensation survey and study. His final salary must be approved by the Asante board of directors. Part I, Lines 4a-b Asante made severance payments to former officers Paul Macuga and Mark Hetz during the tax year 2019. Asante has an executive restoration plan which includes Asante VP& CIO Lee Milligan, MD, ARRMC CEO Scott Kelly, ATRMC CEO Win Howard, AACH CEO Sheila Clough, Chief Quality and Safety Officer James Grebosky, MD, VP of Medical Affairs Eric Loeliger, MD, and CSO Dennie Conrad. This plan states fixed payments will be received at pre-determined intervals from Asante if still employed by Asante in their current roll at the time of vesting. If employment terminates by Asante for any reason prior to vesting, they will not have claim to the funds. Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V, for a broader description. A The Hospital Facilities Authority of the City of Medford Oregon 521378932 794458FX2 2020-07-21 524570640 See Part VI 0 0 0 A 524572269 1923423 30363016 208410890 283874940 1 0 0 1 A 0 1 1 1 1 1 0.00100 0.00000 0.00100 0 0 1 A 0 1 1 0 1 0 0 0 1 A 1 Part I(f) The bonds were issued to pay costs of improvements to the Borrower's hospital facilities, and current refund a portion of the Issuer's outstanding Hospital Revenue Bonds, Series 2005A originally issued on November 17, 2005, a portion of the Issuer's Hospital Revenue Refunding Bonds, Series 2010 originally issued on February 17, 2010 and all of the Issuer's Hospital Revenue Bonds, Series 2002B originally issued on February 5, 2002. Part II, Line 3 The amount differs from the Issue Price in Part I (e) due to interest earnings on invested proceeds. Part III, Line 7 As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of use and/or unrelated trade or business reported in Part III, Line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, Line 2(b) The refunding portion of Bonds has met the 6-month expenditure exception to rebate. Roy Vinyard Asante CEO See Part V X 3000000 5020662 0 1 1 5020662 Schedule L Part II The EO provides supplemental retirement benefits through an alternative funding arrangement the IRS calls "collateral assignment split dollar" (CASD). Although the IRS requires reporting in the loan section ofSchedule L, CASD is not an actual loan--no funds are transferred to the executive. Rather, the "loan" treatment applies because after the executive has received retirement benefits, the EO recovers all of its outlays plus interest.The recovery right is a key advantage of CASD for the EO. Rather than paying retirement benefits to the executive that would never be recovered, under CASD the EO recovers not only its outlays, but also considerationfor the time value of money.CASD works as follows. The EO deposits funds into a cash value life insurance policy on the executive's life. During life, to the extent the executive fulfills service and vesting requirements, the executive can borrowagainst values in the policy to supplement retirement income. Policy performance is closely monitored. If policy performance lags, the executive's borrowing rights are reduced to protect the EO's recoveryrights.At the executive's death, the policy death proceeds are first used to repay the EO its deposits plus compounded interest (at the IRS long-term applicable federal rate). The executive's beneficiary then receivesany projected retirement borrowing the executive did not access during life. Any remaining death proceeds are available to be paid to the executive's beneficiary. Form 990, Part VI, Section B, line 11b Policy Summary: The federal Forms 990 and 990-T are federally mandated legal documents that are highly regulated. Within Asante, they are to be prepared by personnel in the Accounting Department. Additional assistance will be provided by personnel in the Marketing, Compliance, and Executive departments. Before final submission of the documents, they are reviewed by the Manager of Finance, Director of Finance and CFO. After submission the final returns are presented to the Asante Board of Directors. Policy Details: 1. When final audited financial information is available, Accounting personnel will compile the needed information to prepare the appropriate returns for the prior fiscal year. 2. As needed, Accounting will file all appropriate extensions on a timely basis. However, the final submission can never be extended past August 15th of the year following the fiscal year being filed. 3. In addition to normal preparation, Accounting personnel will coordinate with personnel in Marketing, Compliance, and possibly the Executive departments in preparing the various schedules needed to complete the return. All work papers are to be retained in a permanent file. 4. When all necessary information has been compiled, it is to be loaded into appropriate tax software. 5. When completed, a draft return will be reviewed by the Chief Administrative and Finance Officer. After the review, Accounting will clear all review notes and comments. 6. Once reviewed by the CAFO, an additional review will be performed by an outside CPA firm. Accounting will again clear any additional review notes and comments submitted by the outside CPA. 7. Once all reviews and corrections are made, the CAFO will sign all appropriate returns for filing. 8. All returns will then be filed either electronically or paper copy with the appropriate government agency. A copy of each return is to be kept in the Accounting department and a copy of the 990 and 990-T will be kept at corporate headquarters for public display and copying, as requested. 9. The Chief Executive Officer and members of the Board of Directors will look over the final set of returns and make further comments and corrections, as is appropriate. Form 990, Part VI, Section B, line 12c Each year, Asante mails to all Asante Management, key employees, and Board Members a Conflict of Interest Questionaire to comply with Asante's Conflict of Interest Policy# 400-LD-034 and 036. The purpose of the policy is to protect Asante's interests when it is contemplating entering into a transaction or arrangement that might benefit the private interests of a Board member or officer of the corporation. In addition, all Asante employees have an obligation to disclose conflicts of interest or potential conflicts to their supervisor. The Corporate Compliance Officer is responsible for administering, monitoring, and investigating any possible conflicts and make an annual report to the Board of Directors. Form 990, Part VI, Section B, line 15 The Compensation Committee of the Board of Directors annually reviews the compensation of the CEO and other key employees. The review compares the compensation of the CEO and other key employees with compensation data for job incumbents in comparable positions at other healthcare organizations of similar size and scope. At least every two years, the review is conducted and presented to the Compensation Committee by an outside consultant, chosen by the compensation committee. On alternate years, the general market movement is considered and the review is completed and presented by the VP of Human Resources. The Compensation Committee sets the actual annual cash compensation for the CEO and salary ranges for the other key employees. The Committee also sets total compensation opportunity for the CEO and each of the key employees, consistent with the executive compensation philosophy. Minutes of the Committee deliberations and decisions are recorded and maintained. The most recent executive compensation review by an outside consultant was completed in 2019, the VP of HR provided the update recommendations in 2020. Form 990, Part VI, Section C, line 19 Currently, Asante does not make available to the general public copies of its governing documents, conflict of interest policy, or its financial statements. Form 990, Part XI, line 9: Dissolution of JV-Siskiyou Imaging -126,626. Donated Capital 265,029. Asante Ashland Community Hospital 280 Maple St Ashland OR 97520 815427847 Medical Billing OR 65842805 38960833 Asante Asante Three Rivers Medical Center LLC 500 SW Ramsey Grants Pass OR 97527 571181758 Medical Billing OR 192026413 81384608 Asante Asante Community Services LLC 2650 Siskiyou Blvd Medford OR 97504 571181752 Medical Billing OR 0 0 Asante Health Alliance of Southern Oregon 2620 E Barnett Medford OR 97504 371768822 Manage/Improve Population Health OR 547691 123437 asante Southern Oregon Trauma and Emergency Services 2650 Siskiyou Blvd Medford OR 97504 542085981 Medical Billing OR 246423 -1422744 Asante Asante Foundation 2650 Siskiyou Blvd Medford OR 97504 936087366 Fundraising OR 501(C)(3) Line 12b, II Asante 1 Southern Oregon Insurance Company 745 Fort Street Suite 800 Honolulu HI 96813 201578637 Captive Insurance HI 501(C)(3) Line 12b, II Asante 1 Asante Physician Partners 2650 Siskiyou Blvd Medford OR 97504 383849354 Physician Group OR 501(C)(3) Line 3 Asante 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 Asante Foundation C 994492 cash Asante Foundation O 985457 cash APP O 64608975 cash SOII P 1846134 cash