2020-11-05T17:25:10-06:00 2019-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2019-01-01 454789950 CONFLUENCE HEALTH CONF 5096621511 1201 SOUTH MILLER STREET WENATCHEE WA 98801 PETER D RUTHERFORD MD CHIEF EXECUTIVE OFFICER 5096621511 2020-10-29 1 ROBERT GRANNUM P00355876 4252597227 2020-10-29 73.59.64.75 2020-10-29 12:40:07 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C6DE56114614F097EFEFA27A1F452A96C82E7D93 2019 2021-01-29 14:40:06Z PETER D RUTHERFORD MD 1201 SOUTH MILLER STREET WENATCHEE WA 98801 222550508 0 X WWW.CONFLUENCEHEALTH.ORG X 2012 WA IMPROVING HEALTH BY PROVIDING HIGH-QUALITY CARE IN A COMPASSIONATE AND COST-EFFECTIVE MANNER. 15 15 1014 2 0 0 1315221 1211165 187616969 221817649 105690 170951 658006 -649257 189695886 222550508 943652 829221 0 0 65452265 68476123 0 0 0 116855793 151419409 183251710 220724753 6444176 1825755 51171129 54431988 51206935 52151090 -35806 2280898 X IMPROVING HEALTH BY PROVIDING HIGH-QUALITY CARE IN A COMPASSIONATE AND COST-EFFECTIVE MANNER. 0 0 185854168 829221 221168392 CONFLUENCE HEALTH PROVIDES THE ADMINISTRATIVE AND SHARED FUNCTIONS FOR THE HEALTH SYSTEM. IN ADDITION, THE PURPOSES OF THE SYSTEM 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 CARE 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 A 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 BELIEF, 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 THE HEALTH SYSTEM 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. 185854168 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 106 0 1 1014 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 1 0 1 0 0 0 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 2.00 2.00 X X 9600 0 0 GARN CHRISTENSEN TREASURER 2.00 2.00 X X 6600 0 0 PATRICIA WACHTEL VICE CHAIR 2.00 2.00 X X 6600 0 0 FRANK KUNTZ CHAIR 2.00 2.00 X X 5400 0 0 JULIE SMITH MD SECRETARY (THRU 01/19) 2.00 2.00 X X 0 0 0 DOUG WILSON MD BOARD OF DIRECTORS 1.00 2.00 X 9600 0 0 GAUTAM NAYAK MD BOARD OF DIRECTORS 1.00 2.00 X 9600 0 0 JAMES MURRAY MD BOARD OF DIRECTORS 1.00 2.00 X 9600 0 0 TOBY BOND MD BOARD OF DIRECTORS 1.00 2.00 X 9600 0 0 MITCHELL GARRISON MD BOARD OF DIRECTORS 1.00 2.00 X 7200 0 0 DOUG SHAE BOARD OF DIRECTORS 1.00 2.00 X 6600 0 0 GUS HEINICKE BOARD OF DIRECTORS 1.00 2.00 X 6600 0 0 JENNY CRAVENS BOARD OF DIRECTORS 1.00 2.00 X 6600 0 0 KRISTINE LOOMIS BOARD OF DIRECTORS 1.00 2.00 X 6600 0 0 SCOTT DUNCAN BOARD OF DIRECTORS 1.00 2.00 X 6600 0 0 ROBERT TRASK JR BOARD OF DIRECTORS 1.00 2.00 X 6000 0 0 RICK HOURIGAN MD BOARD OF DIRECTORS (THRU 01/19) 1.00 2.00 X 0 0 0 PETER RUTHERFORD CHIEF EXECUTIVE OFFICER 20.00 30.00 X 682051 0 43982 STUART D FREED MD CHIEF MEDICAL OFFICER 20.00 30.00 X 533212 0 42483 JOHN R DOYLE CHIEF FINANCAL OFFICER 20.00 30.00 X 448261 0 42525 JAMES B WOOD CHIEF ADMIN OFFICER (THRU 12/19) 20.00 30.00 X 428583 0 43704 ROBERT J PAGELER CHIEF INFORMATION OFFICER 20.00 30.00 X 328132 0 39677 CORY M FERARI-ZIMMERMAN INTERIM CFO (FROM 12/19) 20.00 30.00 X 238849 0 33329 JAY H JOHNSON SR VP NETWORK STRATEGY 20.00 30.00 X 376348 0 41346 TRACEY A KASNIC SR VP INPATIENT & CNO 20.00 30.00 X 365448 0 34119 JEANINE M ALLEN SR VP CWH OUTPATIENT SERV 20.00 30.00 X 246546 0 40817 FARAZ S AHMED SR VP PRIMARY CARE (THRU 11/19) 20.00 30.00 X 234354 0 29178 PETER N LOLOS JR SR VP FACILITY SUPT SRV (THRU 09/19) 20.00 30.00 X 219776 0 26369 JOELLEN COLSON SR VP ANCILLARY SERVICES 20.00 30.00 X 212717 0 14218 VIKKI L NOYES CHIEF OPERATING OFFICER - CWH 20.00 30.00 X 451531 0 34675 GLENN W ADAMS CHIEF OPERATING OFFICER - WVH 20.00 30.00 X 291517 0 41211 KRIS A DEYERLE VP GENERAL COUNSEL 20.00 30.00 X 265248 0 35268 JULIE A MCALLISTER VP NURSING 20.00 30.00 X 216032 0 37464 SARAH C BROWN VP RISK & REGULATORY 20.00 30.00 X 200776 0 38801 5852181 0 619166 65 0 1 1 EPIC HOSTING LLC BIN 88056 MILWAUKEE WI 53288 BILLING SYSTEM SERVICES 4409650 MEDEFIS PO BOX 5066 NEW YORK NY 10087 TRAVELING NURSE SERVICES 2326200 COMPUNET INC LB 410802 SEATTLE WA 98124 SERVICE AGREEMENTS 1216887 HEALTHCARE RESOURCE GROUP INC 12610 E MIRABEAU PKWY STE 800 SPOKANE VALLEY WA 99216 CODING SERVICES 1083256 KRS TECH LLC 16427 NE 107TH PLACE REDMOND WA 98052 CONSULTING SERVICES 660000 35 1124655 86510 1211165 MANAGEMENT SERVICES 541610 111729132 111729132 MANAGED CARE 541610 108339010 108339010 OTHER OPERATING INCOME 900099 1749507 1749507 221817649 170951 170951 MISCELLANEOUS 900099 -649257 -649257 -649257 222550508 221168392 0 170951 676855 676855 152366 152366 4858823 3887058 971765 48130888 38504710 9626178 2313732 1850986 462746 9208892 7367114 1841778 3963788 3171030 792758 615202 615202 627959 627959 3247282 2597825 649457 852822 682258 170564 5645226 4516181 1129045 11950214 9560171 2390043 2634456 2371010 263446 722513 578010 144503 332954 332954 6176191 5558572 617619 1067876 1067876 MANAGED CARE CLAIM EXPE 114841690 101342044 13499646 TAXES AND LICENSES 2083830 2083830 BAD DEBT EXPENSE 611936 611936 UBI TAX 9258 9258 220724753 185854168 34870585 0 3342926 6451341 209049 507921 5349059 5248119 57826474 22870747 37662164 34955727 4607931 7268880 51171129 54431988 32904428 37956585 18302507 14194505 51206935 52151090 X -35806 2280898 -35806 2280898 51171129 54431988 1825755 490949 0 X 0 1 X 1 1 1 X X X 2 WENATCHEE VALLEY HOSPITAL 455563741 3 1 23916486 0 CENTRAL WASHINGTON HEALTH SERVICES 910171250 3 1 87812646 0 2 111729132 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PART VI, SECTION E, LINE 3A AND 3B THE HEALTH SYSTEM IS ORGANIZED AS A NON-PROFIT, TAX EXEMPT ENTITY UNDER WASHINGTON LAW. THE HEALTH SYSTEM IS A MEANS TO INTEGRATE ITS RELATED HOSPITALS, INCLUDING CENTRAL WASHINGTON HOSPITAL AND WENATCHEE VALLEY HOSPITAL, THAT A BOARD OF DIRECTORS OF THE HEALTH SYSTEM HAVE AUTHORIZED TO BE INCORPORATED, OF WHICH THE HEALTH SYSTEM SHALL BE A SOLE MEMBER AND MANAGED ORGANIZATIONS UNDER A COMMON GOVERNANCE STRUCTURE CONSISTENT WITH THE GOALS AND OBJECTIVE OF THE PARTIES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 139309 139309 0 PART II-B, LINE 1: $100,876 WAS PROVIDED TO CAPITOL ASSOCIATES, INC (CAI) WHO IS A WASHINGTON-BASED BIPARTISAN, LOBBYING, GOVERNMENT RELATIONS AND PUBLIC RELATIONS FIRM. THE ORGANIZATION'S WORK INCLUDES THE PREPARATION OF CONGRESSIONAL TESTIMONY AND THE PLANNING AND EXECUTION OF BRIEFINGS FOR MEMBERS OF CONGRESS AND THEIR STAFF. $38,433 WAS PROVIDED TO DANIELS-BROWN COMMUNICATIONS (DBC) WHO IS A WASHINGTON-BASED MEDIA RELATIONS FIRM. THE ORGANIZATION'S WORK INCLUDES FEDERAL AND STATE LEGISLATIVE ADVOCACY SERVICES, CRISIS COMMUNICATIONS PLANNING AND MANAGEMENT, POLITICAL CAMPAIGN CONSULTING, AND DIPLOMATIC RELATIONS WITH U.S. AND FOREIGN EMBASSIES. 225088 225088 2223750 361168 1862582 14740397 10099498 4640899 40637239 12410081 28227158 34955727 INVESTMENT IN HEALTH ALLIANCE NW 2446747 INVESTMENT IN GX GREENHEALTH EXCHANGE 150000 HEALTH ALLIANCE NW NOTE RECEIVABLE 4672133 7268880 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, 2019 AND 2018, THE HEALTH SYSTEM HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. 1 ALATHEIA RIDING CENTER 2170 SLEEPY HOLLOW HEIGHTS WENATCHEE WA 98801 451552046 501(C)(3) 10000 GENERAL SUPPORT AMERICAN LUNG ASSOCIATION 5601 6TH AVE STE 460 SEATTLE WA 98108 131632524 501(C)(3) 10000 GENERAL SUPPORT AMERICAN MOUNTAIN GUIDES ASSOCIATION 4720 WALNUT ST STE 200 BOULDER CO 80301 841213723 501(C)(3) 22000 GENERAL SUPPORT BOY SCOUTS OF WENATCHEE PO BOX 433 WENATCHEE WA 98801 221576300 501(C)(3) 6000 GENERAL SUPPORT CHELAN-DOUGLAS LAND TRUST PO BOX 4461 WENATCHEE WA 98801 911331348 501(C)(3) 12000 GENERAL SUPPORT COMMUNITY FOUNDATION OF NORTH CENTRAL WASHINGTON 9 SO WENATCHEE AVE WENATCHEE WA 98801 911349486 501(C)(3) 12695 GENERAL SUPPORT CONFLUENCE HEALTH FOUNDATION 518 N CHELAN AVE WENATCHEE WA 98801 911075950 501(C)(3) 250552 GENERAL SUPPORT GWATA 285 TECHNOLOGY CENTER WAY STE 137 WENATCHEE WA 98801 912112603 501(C)(3) 15000 GENERAL SUPPORT MISSION RIDGE SKI EDUCATION FOUNDATION 25 N WENATCHEE AVE STE 25 WENATCHEE WA 98801 237057008 501(C)(3) 7500 GENERAL SUPPORT MOSES LAKE BUSINESS ASSOCIATION PO BOX 1201 MOSES LAKE WA 98837 911606986 501(C)(6) 6250 GENERAL SUPPORT NUMERICA PERFORMING ARTS CENTER 123 N WENATCHEE AVE WENATCHEE WA 98801 911185129 501(C)(3) 9000 GENERAL SUPPORT NURSE WEEK COMMITTEE PO BOX 1882 WENATCHEE WA 98801 454789950 501(C)(3) 6000 GENERAL SUPPORT OUTDOOR DISCOVERY NETWORK 1512 REX ROAD WENATCHEE WA 98801 260691476 501(C)(3) 12500 GENERAL SUPPORT PEOPLE FOR PEOPLE 302 LINCOLN WAY YAKIMA WA 98902 910783225 501(C)(3) 36000 GENERAL SUPPORT THE TRUST FOR PUBLIC LAND 901 5TH ST STE 1520 SEATTLE WA 98164 237222333 501(C)(3) 100000 GENERAL SUPPORT UNITED WAY 105 S MISSION ST WENATCHEE WA 98801 910657766 501(C)(3) 60358 GENERAL SUPPORT UNIVERSITY OF WASHINGTON 1410 NW CAMPUS PARKWAY SEATTLE WA 98195 916001537 501(C)(3) 11000 GENERAL SUPPORT WASHINGTON STATE MEDICAL ASSOCIATION 2001 6TH AVE STE 2700 SEATTLE WA 98121 910462170 501(C)(6) 7500 GENERAL SUPPORT WASHINGTON STATE UNIVERSITY PO BOX 641067 PULLMAN WA 99164 916001108 501(C)(3) 6000 GENERAL SUPPORT WELLNESS PLACE 609 OKANOGAN AVE WENATCHEE WA 98801 911891688 501(C)(3) 20000 GENERAL SUPPORT WENATCHEE BRETHREN BAPTIST 535 OKANOGAN AVE WENATCHEE WA 98801 910604174 501(C)(3) 12000 GENERAL SUPPORT WENATCHEE CHAMBER OF COMMERCE 137 NORTH WENATCHEE AVE WENATCHEE WA 98801 910465430 501(C)(6) 15000 GENERAL SUPPORT WENATCHEE DOWNTOWN ASSOCIATION 103 PALOUSE ST 35 WENATCHEE WA 98801 910823589 501(C)(3) 7500 GENERAL SUPPORT WENATCHEE VALLEY COLLEGE FOUNDATION 1300 5TH ST WENATCHEE WA 98801 237319272 501(C)(3) 7000 GENERAL SUPPORT YMCA 217 ORONDO ST WENATCHEE WA 98801 910578224 501(C)(3) 15000 GENERAL SUPPORT 22 3 HIV PREVENTION AND CARE PROGRAM 80 82876 BCCHP (BREAST, CERVICAL, AND COLON CANCER SCREENING PROGRAM) GRANT 1276 46970 PALLIATIVE CARE - HONORING CHOICES 904 22520 PART I, LINE 2: OUTSIDE ORGANIZATIONS SUBMIT REQUESTS TO THE ORGANIZATION THROUGHOUT THE YEAR. THE REQUESTS ARE SEPARATED BASED ON THE MONETARY VALUE REQUESTED. EACH REQUEST REQUIRES SUPPORT FROM THE REQUESTING ORGANIZATION AS TO THE PURPOSE/USE OF THE FUNDS AND WHETHER THE REQUEST BENEFITS THE COMMUNITY. TWO COMMITTEES REVIEW THE REQUESTS BASED ON THE MONETARY VALUE OF THE REQUEST. X X X 0 0 0 0 0 1 1 0 0 PETER RUTHERFORD CHIEF EXECUTIVE OFFICER 628531 0 53520 0 0 0 21782 0 22200 0 726033 0 0 0 STUART D FREED MD CHIEF MEDICAL OFFICER 491714 0 41498 0 0 0 22915 0 19568 0 575695 0 0 0 JOHN R DOYLE CHIEF FINANCAL OFFICER 409655 0 38606 0 0 0 21782 0 20743 0 490786 0 0 0 JAMES B WOOD CHIEF ADMIN OFFICER (THRU 12/19) 399276 0 29307 0 0 0 17247 0 26457 0 472287 0 0 0 ROBERT J PAGELER CHIEF INFORMATION OFFICER 301838 0 26294 0 0 0 17247 0 22430 0 367809 0 0 0 CORY M FERARI-ZIMMERMAN INTERIM CFO (FROM 12/19) 223928 0 9579 0 5342 0 13566 0 19763 0 272178 0 0 0 JAY H JOHNSON SR VP NETWORK STRATEGY 331965 0 28308 0 16075 0 21782 0 19564 0 417694 0 0 0 TRACEY A KASNIC SR VP INPATIENT & CNO 325165 0 27851 0 12432 0 21782 0 12337 0 399567 0 0 0 JEANINE M ALLEN SR VP CWH OUTPATIENT SERV 226985 0 19561 0 0 0 18717 0 22100 0 287363 0 0 0 FARAZ S AHMED SR VP PRIMARY CARE (THRU 11/19) 186430 0 13480 0 34444 0 9540 0 19638 0 263532 0 0 0 PETER N LOLOS JR SR VP FACILITY SUPT SRV (THRU 09/19) 165284 0 20293 0 34199 0 18105 0 8264 0 246145 0 0 0 JOELLEN COLSON SR VP ANCILLARY SERVICES 195352 0 8202 0 9163 0 14218 0 0 0 226935 0 0 0 VIKKI L NOYES CHIEF OPERATING OFFICER - CWH 415811 0 35720 0 0 0 17247 0 17428 0 486206 0 0 0 GLENN W ADAMS CHIEF OPERATING OFFICER - WVH 260257 0 21462 0 9798 0 19111 0 22100 0 332728 0 0 0 KRIS A DEYERLE VP GENERAL COUNSEL 254316 0 10932 0 0 0 16025 0 19243 0 300516 0 0 0 JULIE A MCALLISTER VP NURSING 199325 0 8939 0 7768 0 16619 0 20845 0 253496 0 0 0 SARAH C BROWN VP RISK & REGULATORY 192314 0 8462 0 0 0 12344 0 26457 0 239577 0 0 0 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 IS REVIEWED, APPROVED, AND PAID BY AN UNRELATED THIRD PARTY, WENATCHEE VALLEY MEDICAL GROUP, FOR SERVICES PERFORMED FOR CONFLUENCE HEALTH. COMPENSATION PAID IN 2019 WAS $575,697. DUSTIN ALLEN FAMILY MEMBER OF KEY EMPLOYEE 58303 EMPLOYMENT 0 NICK LOLOS FAMILY MEMBER OF KEY EMPLOYEE 44357 EMPLOYMENT 0 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 4 THE COMPOSITION OF THE GOVERNING BODY WAS UPDATED TO INCLUDE THE CHIEF ADMINISTRATIVE OFFICER AS AN OFFICER. THE ORGANIZATION'S PURPOSE WAS UPDATED TO INCLUDE REFERENCE TO OPERATING EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC OR EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE. THE RESPONSIBILITY FOR THE CEO TO OVERSEE AND FACILITATE THE PHYSICIAN COMPENSATION COMMITTEE WAS REMOVED. 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 CONFLUENCE HEALTH'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE ON REQUEST. CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION 1201 S MILLER STREET WENATCHEE WA 98801 910171250 HOSPITAL WA 501(C)(3) LINE 3 CONFLUENCE HEALTH 1 WENATCHEE VALLEY HOSPITAL 820 N CHELAN AVE WENATCHEE WA 98801 455563741 HOSPITAL WA 501(C)(3) LINE 3 CONFLUENCE HEALTH 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 0 1 0 0 CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION L 87812646 COST ALLOCATION WENATCHEE VALLEY HOSPITAL L 23916486 COST ALLOCATION