2023-11-02T13:42:57-05:00 2022-12-31 346565596 ERNST & YOUNG US LLP 221 EAST 4TH STREET STE 2900 CINCINNATI OH 45202 990 2022-01-01 911352172 MULTICARE HEALTH SYSTEM MULT 2534598141 PO BOX 5299 TACOMA WA 984150299 JAMES LEE CFO & EVP-POP. BASED CARE 2534038001 2023-11-02 0 JAMES LEE 999009999 0 ABBEY LEIBEL P01517527 5136121400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WILLIAM ROBERTSON PO BOX 5299 TACOMA WA 984150299 4305030374 0 X HTTPS://WWW.MULTICARE.ORG/ X 1987 WA MULTICARE HEALTH SYSTEM'S MISSION IS PARTNERING FOR HEALING AND A HEALTHY FUTURE. 10 10 18413 955 1290837 1064341 199173819 41042119 3572003699 3926955806 113541834 334863569 -91045 4051 3884628307 4302865545 10697954 13992324 0 0 2008960168 2362425726 0 0 0 1676961291 1871033065 3696619413 4247451115 188008894 55414430 5997507394 5895297278 2692174413 3066222058 3305332981 2829075220 X MULTICARE HEALTH SYSTEM'S MISSION IS PARTNERING FOR HEALING AND A HEALTHY FUTURE. 0 0 2826922694 13992324 3144006817 MULTICARE HEALTH SYSTEM (MHS) IS THE LARGEST COMMUNITY-BASED, LOCALLY GOVERNED HEALTHCARE TAX-EXEMPT ORGANIZATION IN THE STATE OF WASHINGTON. MHS OPERATES NINE COMMUNITY BASED HOSPITALS WITH 1,827 LICENSED ADULT BEDS AND 82 LICENSED PEDIATRIC BEDS. DURING 2022 MHS HOSPITALS ADMITTED 78,710 PATIENTS FOR A TOTAL OF 447,312 PATIENT DAYS, PERFORMED 58,463 SURGERIES AND DELIVERED 9,474 BABIES. THERE WERE 13,836 NEWBORN DAYS DURING 2022. THEY ALSO PROVIDED CARE FOR 535,418 OUTPATIENT VISITS AND 545,137 EMERGENCY ROOM VISITS, OF WHICH 1,447 WERE TRAUMA PATIENTS. IN ADDITION, MHS, THROUGH THE COMMUNITY PARTNERSHIP FUND SUPPORTS ORGANIZATIONS WHOSE WORK IS IMPORTANT TO THE HEALTH OF THE COMMUNITIES IT SERVES IN PUGET SOUND AND EASTERN WA. IN 2022 MHS PROVIDED 115 GRANTS TO COMMUNITY ORGANIZATIONS. 459383927 598619741 MULTICARE HEALTH SYSTEM OPERATES A SYSTEM OF MULTI-SPECIALTY CLINICS (MULTICARE) AND A GRID OF HIGHLY SPECIALIZED URGENT CARE CENTERS (INDIGO), THROUGHOUT PIERCE, KING, THURNSTON, KITSAP, SNOHOMISH COUNTIES, AND MULTICARE ROCKWOOD CLINIC LOCATED IN SPOKANE, WA. ROCKWOOD CLINIC IS THE LARGEST OUTPATIENT DIAGNOSTIC AND TREATMENT CENTER IN THE EASTERN WA REGION, WITH MULTIPLE LOCATIONS OFFERING PRIMARY CARE, URGENT CARE AND SPECIALTY CARE. IN 2022 THE INDIGO, MULTICARE UCC AND ROCKWOOD CLINICS PROVIDED 526,680 CLINIC VISITS. THE MULTI-SPECIALTY CLINICS PROVIDED 962,120 PHYSICIAN VISITS, OUTPATIENT VISITS OF 367,323, PERFORMED 1,925 SURGERIES, PROCESSED 2,992,436 LABORATORY WORKLOAD UNITS, 141,185 IMAGING RELATIVE UNITS, (SEE SCHEDULE O)(CONTINUATION FROM PAGE 2) 114,441 ONCOLOGY RELATIVE VALUE UNITS, 149,289 RADIATION ONCOLOGY VALUE UNITS, 1,630 THERAPY VALUE UNITS AND 3,500 PHARMACY WORKLOAD UNITS. THE GIG HARBOR AMBULATORY CENTER PERFORMED SPECIALIST SURGERIES AS FOLLOWS: PEDIATRIC, GENERAL, NEUROLOGIC, VASCULAR, SPINE, ORTHOPEDIC, GENERAL BREAST, PEDIATRIC ORTHOPEDIC, CARDIOTHORACIC, GENERAL BARIATRIC, COLORECTAL, PEDIATRIC NEUROSURGERY. 135799303 122671090 MULTICARE HEALTH SYSTEM OPERATES PRIMARY CARE PHYSICIAN PRACTICES THROUGHOUT PIERCE, SOUTH KING, AND IN THURNSTON COUNTIES. THESE PRACTICES PROVIDED 558,613 PATIENT VISITS DURING 2022. 49582650 61658159 MULTICARE HEALTH SYSTEM'S OTHER PROGRAMS INCLUDE BEHAVIORAL HEALTH, HOME HEALTH SERVICES AND HOSPICE, ADULT DAY HEALTH AND PSYCHOLOGY CHILDREN'S THERAPY UNIT. DURING 2022 THE HOME HEALTH AND HOSPICE PROGRAMS PROVIDED 130,123 CLINIC VISITS, 40,999 HOME HEALTH VISITS, AND ADMITTED 2,657 PATIENTS AND 1,288 PATIENTS, RESPECTIVELY. MULTICARE GOOD SAMARITAN CHILDREN'S THERAPY UNIT (CTU) HELPS INFANTS, CHILDREN AND ADOLESCENTS WHO HAVE SPECIAL NEEDS. IN 2022 CTU SERVED 567 PATIENTS. MULTICARE BEHAVIORAL HEALTH SERVICES (BHS) OFFERS A FULL RANGE OF SERVICES AND AN INTEGRATED APPROACH TO WELLNESS. BHS ADMITTED 609 PATIENTS FOR A TOTAL OF 28,530 PATIENT DAYS. 49582650 61658159 3471688574 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1623 0 1 18413 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 10 10 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA X JASON MITCHELL 2534598059 820 A STREET TACOMA WA 98402 JOHN P FOLSOM DIRECTOR 5.00 0.00 X 0 0 0 SALLY B LEIGHTON SECRETARY 5.00 0.00 X X 0 0 0 TARA PERRY DIRECTOR 5.00 0.00 X 0 0 0 DALE L SOWELL DIRECTOR 5.00 0.00 X 0 0 0 JANINE TERRANO DIRECTOR 5.00 0.00 X 0 0 0 ROBIN THOMASHAUER DIRECTOR 5.00 0.00 X 0 0 0 FRANK TOMBARI TREASURER 5.00 0.00 X X 0 0 0 DEEDRA WALKEY VICE CHAIR 5.00 0.00 X X 0 0 0 JOHN WIBORG CHAIR 5.00 0.00 X X 0 0 0 ROBERT YOST DIRECTOR 5.00 0.00 X 0 0 0 WILLIAM ROBERTSON CEO 56.00 4.00 X 2751828 0 856729 JAMES LEE CFO 50.00 0.00 X 596384 0 11289 FLORENCE CHANG PRESIDENT 60.00 0.00 X 2029026 0 633316 DAVID J CARLSON SRVP,EXEC SOUTH SOUND,PART YEAR 58.00 2.00 X 1453095 0 24027 DAVID R O'BRIEN SRVP,CHIEF PHYS.OFFICER/EXEC.SOUTH SOUND & PAC.REG 60.00 0.00 X 1095048 0 31130 JUNE ALTARAS SRVP,CHIEF NURSING ENTREPRISE 60.00 0.00 X 1112698 0 33443 CHRISTI MCCARREN SRVP,RETAIL HEALTHCARE,PART YEAR 58.00 0.00 X 510401 0 30324 TIMOTHY W LYNCH SRVP,CLINICAL SERVICES(LAB,PHARMACY,BLOOD BANK) 58.00 0.00 X 567380 0 40163 ALEXANDER M JACKSON SVP EXEC.INLAND NW 58.00 0.00 X 609539 0 24852 JEFFREY POLTAWSKY PRES. MARY BRIDGE&PEDIATRIC NETWORK 60.00 0.00 X 667043 0 37251 LEE SANDQUIST MD PHYSICIAN 50.00 0.00 X 2030965 0 32573 NEHAL MASOOD MD PHYSICIAN 50.00 0.00 X 1779223 0 43430 ARCHIE ADAMS MD PHYSICIAN 50.00 0.00 X 1564699 0 45284 ESTHER M PARK-HWANG MD PHYSICIAN 50.00 0.00 X 1436923 0 45425 BENJAMIN Y CHEN MD PHYSICIAN 50.00 0.00 X 1427303 0 47355 JAMES MCMANUS FORMER CFO 0.00 0.00 X 1342143 0 1587 20973698 0 1938178 5194 1 1 0 TRAVEL NURSE ACROSS AMERICA LLC 5020 NORTHSHORE DR N LITTLE ROCK AZ 72118 STAFFING 268408113 LOCUMSMART LLC 315 WEST 36TH STREET NEW YORK NY 10018 CONSULTING 14584548 AQUITY SOLUTIONS LLC POBOX 746366 ATLANTA GA 30374 CLINICAL DOCUMENTATION SVCS 14214693 ACCENTURE INTERNATIONAL LTD 29889 NETWORK PL CHICAGO IL 60673 CONSULTING 10799460 COLVOS CONSTRUCTION LLC 711 COURT C TACOMA WA 98402 CONSTRUCTIONS 7988642 136 17916575 23125544 41042119 HEALTHCARE SERVICES 622110 3200577039 3200242154 334885 AMBULATORY SRVS & UCC 621493 575167591 575010661 156930 OFFICES OF PHYSICIANS 621111 100934179 100934179 HOME HEALTH 621610 24107577 24107577 OUTPATIENT MENTAL HLTH 621420 20277611 20277611 5891809 5891809 3926955806 32917291 799022 32118269 301946278 0 301946278 301946278 301946278 2168880 2164829 4051 4051 4302865545 3926463991 1290837 334068598 13992324 13992324 13114966 11794592 1320374 1343730 1211727 132003 2065748468 1861427835 204320633 54509691 49154840 5354851 102717565 92626933 10090632 124991306 109522016 15469290 6064953 1068969 4995984 544500 544500 290995 290995 14960114 5509139 9450975 17221613 15529819 1691794 74132895 66850326 7282569 9540049 8709217 830832 79573 79573 56198334 50677596 5520738 136633439 123211024 13422415 59196903 53381596 5815307 SUPPLIES 656213859 653631092 2582767 CORPORATE ALLOCATION 430708879 430708879 WA HOSP. SAFETY NET PRO 127651933 127651933 PROVISION FOR BAD DEBTS 107408619 107408619 174186407 118249404 55937003 4247451115 3471688574 775762541 0 269538752 450400586 476708338 590639712 56384445 60067195 36465764 54591495 3642734314 1606072632 1913642302 2036661682 2094811365 515720000 1968205260 634236428 734731348 5997507394 5895297278 573937046 589980859 1533449304 1914298630 584788063 561942569 2692174413 3066222058 X 3305332981 2829075220 3305332981 2829075220 5997507394 5895297278 X 55414430 -531405855 -266335 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 290995 0 0 290995 0 PART II-B, LINE 1: LINE 1(G) - PAYMENTS TO LOBBYING FIRMS (INDEPENDENT CONTRACTORS) TO ACT AS OUR LIAISON WITH STATE AND FEDERAL GOVERNMENTS ON HEALTH CARE ISSUES AND THE PORTION OF MEMBERSHIP DUES PAID TO HOSPITAL ASSOCIATIONS WHICH IS USED FOR LEGISLATIVE AND LOBBYING ACTIVITIES. 147209581 147209581 2139724708 806363468 1333361240 146734921 97413948 49320973 1037408549 702295216 335113333 171656555 171656555 2036661682 HEDGE FUNDS-PRIVATE INVESTMENTS FUNDS 1535523260 F LIMITED PARTNERSHIPS-PRIVATE EQUITY 432682000 F 1968205260 OTHER ASSETS 339310981 ACCRUED PENSION ASSSET, EXECUTIVE CAA, TOP HAT 457(B) 117563512 BONDS HELD IN TRUST 379867 RIGHT OF USE LEASE ASSET, NET 185134037 NET INVESTMENT IN LEASE 22654793 DONOR RESTRICTED ASSETS HELD FOR LONG-TERM PURPOSES 46192276 MARK TO MARKET BASIS SWAP 23495882 734731348 LONG TERM RIGHT OF USE LEASE LIABILITY 192987086 ACCRUED PENSION AND MALPRACTICE 211395195 ACCRUED INTEREST PAYABLE 23642673 INTEREST RATE SWAP 9469577 EST.THIRD PARTY PAYOR SETTLE. 4781444 OTHER LIABILITIES 40257240 DUE TO AFFILIATES 79409354 561942569 X PART X, LINE 2: THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MULTICARE HEALTH SYSTEM FOOTNOTE READS: "ASC SUBTOPIC 740 10, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN MHS' CONSOLIDATED FINANCIAL STATEMENTS. THIS TOPIC ALSO PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ONLY TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD AT THE EFFECTIVE DATE MAY BE RECOGNIZED OR CONTINUE TO BE RECOGNIZED UPON ADOPTION. IN ADDITION, THIS TOPIC PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. OTHER THAN MEDIS, INC., PHYSICIANS OF SOUTHWEST WASHINGTON, LLC AND OLYMPIC SPORTS & SPINE, PLLC, WHICH ARE ALL TAXABLE ENTITIES, ALL OF THE OTHER ENTITIES HAVE OBTAINED DETERMINATION LETTERS FROM THE INTERNAL REVENUE SERVICE THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME." 1 1 X 1 X 300.000000000000 1 X 500.000000000000 1 1 0 1 1 52627553 52627553 0.01270 1036745000 615857000 420888000 0.10170 0 0 1089372553 615857000 473515553 0.11440 33 36354 14364015 6315875 8048140 0.00190 9 93 30362291 949440 29412851 0.00710 28 64218 61314766 31984317 29330449 0.00710 1 217785 15600 202185 0.00000 3 114 1227931 0 1227931 0.00030 74 100779 107486788 39265232 68221556 0.01640 74 100779 1196859341 655122232 541737109 0.13080 2 15 95190 95190 0.00000 29 3505375 1501223 228192 1273031 0.00030 31 3505390 1596413 228192 1368221 0.00030 1 107408619 3197000 485650885 612957306 -127306421 X 1 1 9 1 MULTICARE TACOMA GENERAL HOSPITAL (TG) 315 MARTIN LUTHER KING JR WAY TACOMA WA 98405 WWW.MULTICARE.ORG/TACOMA-GENERAL-HOSPI 00000176 X X X X X A 2 MULTICARE GOOD SAMARITAN HOSPITAL (GSH) 401 15TH AVE SE PUYALLUP WA 98372 WWW.MULTICARE.ORG/GOOD-SAMARITAN-HOSPI 60221541 X X X X A 3 MULTICARE DEACONESS HOSPITAL (DEAC) 800 W 5TH AVENUE SPOKANE WA 99204 WWW.MULTICARE.ORG/DEACONESS-HOSPITAL/ 60769397 X X X A 4 MULTICARE AUBURN MEDICAL CENTER (AUB) 202 NORTH DIVISION STREET AUBURN WA 98001 WWW.MULTICARE.ORG/AUBURN-MEDICAL-CENTE 60311052 X X X A 5 MULTICARE ALLENMORE HOSPITAL (ALLENMORE) 1901 SOUTH UNION TACOMA WA 98405 WWW.MULTICARE.ORG/ALLENMORE-HOSPITAL/ 00000176 X X X A 6 MULTICARE VALLEY HOSPITAL (VALLEY) 12606 EAST MISSION AVE SPOKANE VALLEY WA 99216 WWW.MULTICARE.ORG/VALLEY-HOSPITAL/ 60769398 X X X A 7 MULTICARE CAPITAL MEDICAL CENTER (CAPMED) 3900 CAPITAL MALL DR SW OLYMPIA WA 985 OLYMPIA WA 98502 HTTPS://WWW.MULTICARE.ORG/LOCATION/CAP 61279406 X X X A 8 MARY BRIDGE CHILDREN'S HOSPITAL (MBRIDGE) 317 MARTIN LUTHER KING JR WAY TACOMA WA 98405 WWW.MULTICARE.ORG/MARY-BRIDGE-HOSPITAL 00000175 X X X X X A 9 MULTICARE COVINGTON HOSPITAL (COV) 17700 SE 272ND ST COVINGTON WA 98042 HTTPS://WWW.MULTICARE.ORG/COVINGTON-ME 60803817 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTP://WWW.MULTICARE.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X X 1 22 1 HTTP://WWW.MULTICARE.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 300.000000000000 500.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.MULTICARE.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MULTICARE.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MULTICARE.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: MULTICARE TACOMA GENERAL HOSPITAL (TG), - FACILITY 4: MULTICARE AUBURN MEDICAL CENTER (AUB), - FACILITY 5: MULTICARE ALLENMORE HOSPITAL (ALLENMORE), - FACILITY 6: MULTICARE VALLEY HOSPITAL (VALLEY), - FACILITY 8: MARY BRIDGE CHILDREN'S HOSPITAL (M.BRIDGE), - FACILITY 2: MULTICARE GOOD SAMARITAN HOSPITAL (GSH), - FACILITY 3: MULTICARE DEACONESS HOSPITAL (DEAC), - FACILITY 7: MULTICARE CAPITAL MEDICAL CENTER (CAPMED), - FACILITY 9: MULTICARE COVINGTON HOSPITAL (COV) GROUP A-FACILITY 1 -- TG,GSH,AUB,ALLEN,MB,DEAC,VALLEY,COV,CAPM PART V, SECTION B, LINE 5: DURING 2022 MULTICARE HEALTH SYSTEM WORKED TO COMPLETE THE NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). ADDITIONALLY, THE PRIORITIES AND IMPLEMENTATION STRATEGIES FOR 2022 CHNA WERE SELECTED AND APPROVED. PUBLISHED IN DECEMBER 2022, THE WORK ON IMPLEMENTATION STRATEGIES IS SCHEDULED FOR 2023,2024, 2025.COMMUNITY ENGAGEMENT PROCESS: MULTICARE HEALTH SYSTEM (MULTICARE) WORKED WITH THE TACOMA-PIERCE COUNTY HEALTH DEPARTMENT, PUBLIC HEALTH - SEATTLE AND KING COUNTY, THURSTON COUNTY PUBLIC HEALTH AND THE SPOKANE REGIONAL HEALTH DISTRICT TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OF ITS HOSPITAL SERVICE AREAS, FEATURING INPUT FROM COMMUNITY LEADERS AND RESIDENTS REPRESENTING MULTIPLE SECTORS AND POPULATION GROUPS. COMMUNITY INPUT: THE CHNA INCLUDES PRIMARY DATA GATHERED FROM COMMUNITY SURVEYS, WORKSHOPS AND STAKEHOLDER INTERVIEWS, IN ADDITION TO INFORMATION COLLECTED FROM SECONDARY QUANTITATIVE SOURCES. PIERCE COUNTY: COMMUNITY WORKSHOPS (FOCUS GROUPS) AND STAKEHOLDER INTERVIEWS WERE CONDUCTED. THREE FOCUS GROUPS WERE HELD. THE POPULATIONS OF INTEREST WERE SELECTED BASED ON GAPS IDENTIFIED IN PREVIOUS ASSESSMENTS, THE NEED FOR TRUST BUILDING AND RECOGNIZED HEALTH DISPARITIES. FOCUS GROUPS WERE HELD WITH THE FOLLOWING: LGBTQ ADULTS, YOUTH (AGES 14 - 17), PEOPLE EXPERIENCING HOMELESSNESS. ALL THREE FOCUS GROUPS INCLUDED PEOPLE REPRESENTING DIVERSE RACE, ETHNICITY, GENDER, AND SEXUAL ORIENTATIONS. WE CONDUCTED TEN INTERVIEWS WITH ORGANIZATIONAL LEADERS ACROSS SEVEN SECTORS. MULTICARE AND VIRGINIA MASON FRANCISCAN PROVIDED THE HEALTH DEPARTMENT WITH MORE THAN 30 NAMES OF SUGGESTED LOCAL LEADERS. TEN PARTICIPANTS WERE SELECTED BASED ON THE FOLLOWING CRITERIA: 1. INDIVIDUAL IS EITHER A PERSON OF COLOR OR REPRESENTS/ WORKS ON BEHALF OF MARGINALIZED POPULATIONS. 2. REPRESENTS KEY SECTORS OF BUSINESS, NON-PROFIT, EDUCATION, TRANSPORTATION, HEALTH AND HUMAN SERVICES, LOCAL GOVERNMENT, AND LAW ENFORCEMENT/ FIRST RESPONDERS. 3. WAS NOT INTERVIEWED FOR THE PREVIOUS 2018-2019 CHNA. 4. AVAILABLE WITHIN THE PROJECT TIMELINE.QUESTIONS INCLUDED: WHAT ARE THE MOST IMPORTANT ISSUES AND CONCERNS YOU (OR YOUR CUSTOMERS/CONSTITUENTS) ARE CURRENTLY FACING, HOW AND WHERE ARE YOU CURRENTLY SEEING EVIDENCE OF RACISM IN PIERCE COUNTY, WHAT DO YOU THINK NEEDS TO CHANGE, WHAT DO YOU THINK HEALTHCARE CAN DO TO HELP?SPOKANE COUNTY: KEY INFORMANT INTERVIEWS AND COMMUNITY CONVERSATIONS WERE CONDUCTED. MANY OF THE INDIVIDUALS AND ORGANIZATIONS INCLUDED WERE IDENTIFIED AS HAVING BEEN MOST IMPACTED BY COVID-19 AND THEIR HEALTH OUTCOMES EXACERBATED BY INEQUITIES. WITHIN THESE INTERVIEWS, EIGHT THEMES EMERGED THAT ALIGNED WITH HOW THESE ORGANIZATIONS SEE HEALTH AND WELL-BEING IN SPOKANE.ADDITIONALLY, A NEEDS ASSESSMENT SPECIFIC TO THE LGBTQ COMMUNITY WAS CONDUCTED ONLINE THROUGH SOCIAL MEDIA CHANNELS AND IN PERSON FROM APRIL TO JULY 2021. RESPONDENTS WERE 357 MEMBERS OF THE SPOKANE COUNTY LBTQ COMMUNITY BETWEEN THE AGES OF 12 AND 83 YEARS OLD, INCLUDING 57 YOUTH (AGES 12-17 YEARS), 170 YOUNG ADULTS (AGES 18-34 YEARS), AND 127 ADULTS AGES 35 YEARS AND OLDER.KING COUNTY: SINCE THE LAST CHNA IN 2019, COMMUNITY-BASED ORGANIZATIONS AND CLINICS, STATE AND LOCAL AGENCIES, COALITIONS, SCHOOLS, AND HOSPITALS HAVE CONTINUED TO ENGAGE WITH THE PEOPLE THEY SERVE TO HELP ELEVATE SPECIFIC COMMUNITY CONCERNS AND STRENGTHS. TO ENHANCE OUR UNDERSTANDING OF KING COUNTY RESIDENTS' PRIORITIES LEADING UP TO THE PANDEMIC, WE REVIEWED 48 COMMUNITY NEEDS ASSESSMENTS, STRATEGIC PLANS, OR REPORTS PRODUCED BETWEEN 2018 AND 2020 IN COLLABORATION WITH PUBLIC HEALTH AND MULTIPLE HOSPITAL SYSTEMS IN KING COUNTY. TOGETHER WE SOUGHT PUBLICLY AVAILABLE INFORMATION REPRESENTING REGIONS THROUGHOUT KING COUNTY, SPECIFIC POPULATIONS, AND FOCUS AREAS INCLUDING FOOD, PHYSICAL ACTIVITY, HOUSING, AND TRANSPORTATION. EACH RESOURCE HAD A COMMUNITY ENGAGEMENT COMPONENT FROM WHICH WE SUMMARIZED THEMES. THE 48 ASSESSMENTS WERE CONDUCTED BY AND FOCUSED ON VULNERABLE POPULATIONS TO INCLUDE: CLIENTS OF YOUTH SERVICES, CLIENTS OF AGING AND DISABILITY SERVICES, CLIENTS OF INDIAN HEALTH SERVICES, RESIDENTS OF MULTIPLE CITIES AND MUNICIPALITIES IN KING COUNTY.THURSTON COUNTY: VIRTUAL AND IN-PERSON INTERVIEWS WERE CONDUCTED WITH 28 KEY INFORMANTS IN BEGINNING SEPTEMBER 2022. KEY INFORMANTS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES DIVERSE COMMUNITIES. EFFORTS WERE MADE TO ENGAGE KEY INFORMANTS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES.INTERVIEWS WERE FACILITATED BY THURSTON COUNTY PUBLIC HEALTH AND SOCIAL SERVICES DEPARTMENT STAFF AND BY PROVIDENCE SWEDISH SOUTH PUGET SOUND STAFF. THE KEY ORGANIZATIONS INVOLVED IN THE VARIOUS SURVEYS. FOCUS GROUPS AND KEY INFORMANT INTERVIEWS INCLUDE: CENTRO LATINO CLOVER PARK SCHOOL DISTRICT/LAKES HIGH SCHOOL DEGREES OF CHANGE EMERGENCY FOOD NETWORK FIRST 5 FUNDAMENTALS FRANKLIN PIERCE SCHOOL DISTRICT GRADUATE TACOMA GREATER TACOMA COMMUNITY FOUNDATION MARY BRIDGE CHILDREN'S OASIS YOUTH CENTERPIERCE COLLEGEPIERCE TRANSIT TACID TACOMA COMMUNITY COLLEGE TACOMA HOUSING AUTHORITY TACOMA PIERCE COUNTY COALITION TO END HOMELESSNESS TACOMA PUBLIC SCHOOLS PIERCE TRANSITRAINBOW CENTERTHURSTON REGIONAL PLANNING COUNCILCHOICE REGIONAL HEALTH NETWORK/CASCADE PACIFIC ACTION ALLIANCEWASHINGTON STATE LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER (LGBTQ) COMMISSIONTHURSTON COUNTY PRETRIAL SERVICES DEPARTMENTDIVERSITY ALLIANCE OF THE PUGET SOUNDLEWIS-MASON-THURSTON AREA AGENCY ON AGINGFAMILY SUPPORT CENTER OF SOUTH SOUND COMMUNITY YOUTH SERVICESTHURSTON CLIMATE ACTION TEAMOLYMPIA CRISIS RESPONSE UNITSAFE KIDS THURSTON COUNTY CHILD CARE ACTION COUNCILTOGETHER!THE OLYMPIA FREE CLINICTHURSTON THRIVESINTERFAITH WORKSROCHESTER ORGANIZATION OF FAMILIES COMMUNITY SERVICESMI CHIANTLATHURSTON COUNTY BOARD OF COUNTY COMMISSIONERSINNOVATIONS HUMAN TRAFFICKING COLLABORATIVESOUTH SOUND BEHAVIORAL HOSPITALST. MARTIN'S UNIVERSITY STUDENT HEALTH CENTERYELM COMMUNITY SCHOOLSSOUTH SOUND PARENT TO PARENTLACEY PARKS, CULTURE, AND RECREATION VALLEY VIEW HEALTH CENTERTHURSTON COUNTY PUBLIC HEALTH AND SOCIAL SERVICES DEPARTMENTFAMILY EDUCATION AND SUPPORT SERVICESCOMMUNITY VOICE AMERICAN INDIAN COMMUNITY CENTERBIG TABLECARL MAXEY CENTERGREATER SPOKANE INCORPORATEDTHE NATIVE PROJECTNORTHEAST WASHINGTON EDUCATIONAL SERVICE DISTRICT 101SPOKANE NEIGHBORHOOD ACTION PARTNERSSPOKANE POLICE DEPARTMENTARC OF SPOKANEASIAN PACIFIC ISLANDER COALITIONCONTINUUM OF CAREPEOPLE FIRST LILAC CHAPTERMUJERES IN ACTIONMUSLIMS FOR COMMUNITY ACTION AND SUPPORTPACIFIC ISLANDER COMMUNITY ASSOCIATIONSPOKANE IMMIGRANT RIGHTS COALITIONVULNERABLE ADULTS LINKS UNITEDWORLD RELIEFYOUTH ADVISORY LUTHERAN SERVICES.INTERNAL STAKEHOLDER REVIEW MEETINGS.FINALLY, THE ASSESSMENT PROCESS INVOLVED INVITING KEY LEADERS AT MULTICARE TO REVIEW THE RESULTS OF THE PREVIOUS COMMUNITY INPUT, AS WELL AS RELEVANT HEALTH INDICATOR DATA (MAY 2022). DURING THESE MEETINGS EXECUTIVES, PHYSICIAN, NURSES, AND OUTPATIENT LEADERS WERE PRESENTED WITH THE SELECTED HEALTH PRIORITIES FOR EACH HOSPITAL/ REGION, AS DETERMINED BY THE RESPECTIVE HEALTH DEPARTMENTS USING THE FOLLOWING CRITERIA:1. WAS THE HEALTH CONCERN OR INDICATOR SIGNIFICANTLY WORSE IN THE HOSPITAL SERVICE AREA THAN IN THE STATE?2. WAS THE HEALTH CONCERN TRENDING WORSE OVER TIME?3. WAS A HEALTH CONCERN REPEATEDLY VOICED DURING THE COMMUNITY ENGAGEMENT PORTION OF THE ASSESSMENT?4. DOES THE HEALTH CONCERN HAVE HEALTH INEQUITIES ASSOCIATED WITH RACE, ETHNICITY OR GENDER? GROUP A-FACILITY 1 -- TG,GSH,AUB,ALLEN,MB,DEAC,VALLEY,COV,CAPM PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH MORE HOSPITAL FACILITIES, AS FOLLOWS:MULTICARE TACOMA GENERAL HOSPITAL,MULTICARE GOOD SAMARITAN HOSPITAL,MULTICARE AUBURN MEDICAL CENTER,MULTICARE ALLENMORE HOSPITAL,MULTICARE MARY BRIDGE CHILDREN'S HOSPITAL,MULTICARE DEACONESS HOSPITAL,MULTICARE VALLEY HOSPITAL,MULTICARE COVINGTON HOSPITAL,MULTICARE CAPITAL MEDICAL CENTER,CHI FRANCISCAN HEALTH,KING COUNTY HOSPITALS FOR A HEALTHY COMMUNITY. GROUP A-FACILITY 1 -- TG,GSH,AUB,ALLEN,MB,DEAC,VALLEY,COV,CAPM PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH ORGANIZATIONS OTHER THAN THE HOSPITAL FACILITIES AS FOLLOWS:TACOMA PIERCE COUNTY HEALTH DEPARTMENT,PUBLIC HEALTH SEATTLE KING COUNTY,THURSTON COUNTY PUBLIC HEALTH & SOCIAL SERVICES DEPARTMENT,SPOKANE REGIONAL HEALTH DISTRICT,PRIORITY SPOKANE. GROUP A-FACILITY 1 -- TG,GSH,AUB,ALLEN,MB,DEAC,VALLEY,COV,CAPM PART V, SECTION B, LINE 7D: LINE 7 D -THE CHNA IS BROADLY DISTRIBUTED TO COMMUNITY PARTNERS, WHO SHARE THESE REPORTS INTERNALLY AND EXTERNALLY THROUGH A COMPUTER-BASED LEARNING MODULE AVAILABLE TO MULTICARE EMPLOYEES AND THROUGH PRESENTATIONS WITH COMMUNITY GROUPS, INCLUDING LOCAL UNIVERSITIES, COMMUNITY SERVICE ORGANIZATIONS, COMMUNITY COALITIONS, REGIONAL BOARDS AND COUNCILS, HOSPITAL LEADERS, AND DEPARTMENTAL STAFF. GROUP A-FACILITY 1 -- TG,GSH,AUB,ALLEN,MB,DEAC,VALLEY,COV,CAPM PART V, SECTION B, LINE 11: IN CONJUNCTION WITH THE CHNA, THE REGIONAL BOARDS FOR EACH OF THE MULTICARE HOSPITALS ADOPTED AN IMPLEMENTATION STRATEGY IN DECEMBER 2022 RELATED TO THE 2022 CHNA. MULTICARE WILL ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS BETWEEN 2023 AND 2025: - BEHAVIORAL HEALTH/ MENTAL HEALTH: ALLENMORE, AUBURN, COVINGTON, DEACONESS, GOOD SAMARITAN, TACOMA GENERAL, VALLEY HOSPITAL.- ACCESS TO CARE: THE NEED IS PREDOMINANT FOR THE HOSPITALS LOCATED IN THE PUGET SOUND AREA SUCH AS: ALLENMORE, AUBURN, CAPITAL, COVINGTON, GOOD SAMARITAN, MARY BRIDGE, TACOMA GENERAL.- CHRONIC DISEASE MANAGEMENT - SPECIFICALLY OBESITY, CANCER, DIABETES, HEART DISEASE/HYPERTENSION: ALLENMORE, AUBURN, CAPITAL, COVINGTON, GOOD SAMARITAN, MARY BRIDGE, TACOMA GENERAL.- MATERNAL AND CHILD HEALTH: ALLENMORE, CAPITAL, GOOD SAMARITAN, MARY BRIDGE, TACOMA GENERAL.- VIOLENCE AND DOMESTIC VIOLENCE: MARY BRIDGE CHILDREN'S HOSPITAL, DEACONESS AND VALLEY HOSPITALS.- HOUSING AND HOMELESSNESS: THE NEED WAS IDENTIFIED FOR THE TWO HOSPITALS LOCATED IN EASTERN WA, SPOKANE AREA, DEACONESS AND VALLEY HOSPITALS. - IMMUNIZATIONS: CAPITAL MEDICAL CENTER IN OLYMPIA, WA.THROUGHOUT 2022 MHS WORKED ON BRINGING TO A COMPLETION THE NEEDS IDENTIFIED IN THE 2019 CHNA.AS A RESULT, IN 2022 THE FOLLOWING STRATEGIES WERE EMPLOYED TO COMPLETE THE 2019 IDENTIFIED COMMUNITY NEEDS:ACCESS TO CARE- IN 2022, MULTICARE HEALTH SYSTEM (MHS) MADE SIGNIFICANT STRIDES IN IMPROVING ACCESS TO CARE. FIRSTLY, WE EXPANDED OUR SERVICES TO REACH UNDERSERVED AND RURAL COMMUNITIES, ENSURING THAT MORE INDIVIDUALS HAD ACCESS TO HEALTHCARE FACILITIES AND RESOURCES. TO ENHANCE CONVENIENCE FOR PATIENTS, WE ESTABLISHED THE PULSE VIRTUAL HEART FAILURE CLINIC, ENABLING PHYSICIANS AND PATIENTS TO AVOID LONG 2-HOUR DRIVES FOR APPOINTMENTS. MHS IMPLEMENTED VIRTUAL HEALTH INPATIENT SPECIALTY SERVICES, FURTHER ENHANCING ACCESS TO SPECIALIZED MEDICAL CARE. THROUGHOUT THE YEAR, MHS PROVIDED A TOTAL OF 181,235 VISITS TO OUR VALUED PATIENTS, ENSURING THEIR MEDICAL NEEDS WERE MET. ADDITIONALLY, MHS PRIORITIZED DENTAL HEALTH IN THE COMMUNITY. THROUGH OUR PARTNERSHIP WITH MEDICAL TEAMS INTERNATIONAL, IT PROVIDED $144,527 WORTH OF FREE DENTAL VISITS TO UNDERSERVED AND UNDERINSURED INDIVIDUALS, PROMOTING ORAL HEALTH AND WELL-BEING FOR ALL. BEHAVIORAL HEALTH- IN 2022 MHS CONTINUED FOCUSING ON GROWING OUR MODEL OF INTEGRATED BEHAVIORAL HEALTH CARE WITHIN BOTH MULTICARE MEDICAL ASSOCIATE AND MARY BRIDGE CLINICS. THIS MODEL OF CARE IS DESIGNED TO SUPPORT PRIMARY CARE AND PEDIATRIC CLINICS BY PROVIDING HIGHLY ACCESSIBLE AND COLLABORATIVE EMBEDDED THERAPY SERVICES, AS WELL AS ACCESS TO PSYCHIATRIC PROVIDERS AND MEDICATION TREATMENT RECOMMENDATIONS. THIS PROGRAM STARTED IN SPRING OF 2022 AND CONTINUES TO GROW AS WE SEE STRONG EVIDENCE OF QUALITY PATIENT CARE, PRIMARY CARE PROVIDER SATISFACTION AND FINANCIAL SUSTAINABILITY. ADDITIONALLY, IN 2022 MHS CONTINUED TO EXPAND SERVICES TO ADULTS, CHILDREN, AND FAMILIES BY ENHANCING OUR PARTNERSHIP WITH QUARTET HEALTH AND OTHER COMMUNITY STAKEHOLDERS. THROUGH UTILIZATION OF QUARTET HEALTH, IN THE INLAND NORTHWEST REGION, MHS RECEIVED 13,869 REFERRALS AND WE MARKED 3,992 PATIENTS AS HAVING ATTENDED AT LEAST ONE APPOINTMENT. THIS RESULTED IN INCREASED ACCESS TO BEHAVIORAL HEALTH SERVICES.CANCER- IN 2022, MHS ACTIVELY SUPPORTED THE COMMUNITY IN CANCER-RELATED INITIATIVES. THEY SPONSORED FREE BREAST CANCER SCREENING EVENTS FOR UNINSURED INDIVIDUALS, PROVIDING VITAL ACCESS TO EARLY DETECTION SERVICES. ADDITIONALLY, MULTICARE HOSTED EDUCATIONAL EVENTS FOR CANCER SURVIVORS, FOCUSING ON LIFESTYLE CHOICES LIKE DIET AND PHYSICAL ACTIVITY TO REDUCE THE RISK OF CANCER RECURRENCE AND IMPROVE OVERALL WELL-BEING. TO ENHANCE HEALTHCARE FOLLOW-UP, MULTICARE ESTABLISHED A PULMONARY NODULE CLINIC, ENSURING TIMELY AND THOROUGH EVALUATIONS OF SUSPICIOUS FINDINGS ON LUNG RADIOLOGY STUDIES. THESE EFFORTS DEMONSTRATE MULTICARE'S COMMITMENT TO ADDRESSING CANCER-RELATED NEEDS IN THE COMMUNITY AND PROMOTING BETTER HEALTH OUTCOMES.CHILDHOOD IMMUNIZATIONS- MULTICARE ACTIVELY PROMOTED CHILDHOOD IMMUNIZATIONS IN 2022 AS A PRIMARY SOURCE FOR COVID VACCINES FOR CHILDREN UNDER 5 IN PIERCE COUNTY. WE SUCCESSFULLY PASSED A WA DEPARTMENT OF HEALTH SITE VISIT, ENSURING HIGH STANDARDS OF VACCINATION ADMINISTRATION. COLLABORATING WITH THE COVID VACCINE MOBILE UNIT, WE CO-HOSTED 49 EVENTS IN PIERCE AND SOUTH KING COUNTIES, OFFERING COVID AND VFC VACCINES. WE HELD 32 EVENTS IN PIERCE COUNTY AND 17 EVENTS IN SOUTH KING COUNTY. ADDITIONALLY, WE PARTNERED WITH ANNIE WRIGHT UPPER SCHOOL TO VACCINATE FOREIGN EXCHANGE STUDENTS AND HOSTED WEEKLY POP-UP CLINICS IN DOWNTOWN PUYALLUP IN COLLABORATION WITH MARY BRIDGE/MULTICARE WIC OFFICES. IN SUPPORT OF OTHER HEALTHCARE PROVIDERS, WE PARTNERED WITH TACOMA FAMILY MEDICINE, MARY BRIDGE PEDIATRICS - AUBURN, AND MARY BRIDGE PEDIATRICS - EVERGREEN, ADMINISTERING VACCINES TO THEIR PATIENTS DURING STAFFING, LOCATION, OR EQUIPMENT CHALLENGES. FURTHERMORE, WE COLLABORATED WITH MARY BRIDGE CHILD LIFE AND OLAF, THE FACILITY DOG, FOR POSITIVE VACCINATION EXPERIENCES. MULTIPLE NEWS SEGMENTS HIGHLIGHTED THE IMPACT OF OLAF AND OUR CLINICS.IN 2022, MHS ADMINISTERED A TOTAL OF 10,551 VACCINES FOR CHILDREN AGED 0-18, INCLUDING 8,287 CHILDHOOD VACCINES (EXCLUDING COVID VACCINES). OUR DEDICATION TO INCREASING IMMUNIZATION RATES SAFEGUARDS THE HEALTH OF CHILDREN IN OUR COMMUNITY.INJURIES (INTENTIONAL) -IN ADDITION TO MANY OTHER THINGS IN 2022, MHS CONTINUED DOMESTIC VIOLENCE WORK FROM THE PREVIOUS YEAR BY CONTINUING TO PARTNER WITH THE YWCA AND LUTHERAN COMMUNITY SERVICES TO IMPLEMENT DOMESTIC VIOLENCE LEARNING TRAININGS AND CONTINUED TO PARTICIPATE IN DOMESTIC VIOLENCE RELATED COALITIONS.INJURIES (UNINTENTIONAL) IN 2022, MHS SUPPORTED STOP THE BLEED WA BY IMPLEMENTING COURSES HELD AT TACOMA GENERAL HOSPITAL FOR THE COMMUNITY. MULTICARE SECURITY OFFICERS WERE TRAINED TO BETTER RESPOND TO EMERGENCIES ON CAMPUS. MHS PARTICIPATED IN THE PIERCE COUNTY FALL PREVENTION COALITION FALL PREVENTION: STEPPING AHEAD FOR A FALLS FREE COMMUNITY POWER POINT. TRAUMA EDUCATION WAS PROVIDED TO HOSPITAL STAFF AND OUR RURAL COMMUNITY PARTNERS THROUGH COURSES AS ADVANCED TRAUMA LIFE SUPPORT AND RURAL TRAUMA TEAM DEVELOPMENT COURSESMATERNAL AND CHILD HEALTH -IN 2022 MULTICARE'S MATERNAL/CHILD HEALTH EFFORTS PRIORITIZE ACCESSIBILITY THROUGH TELEHEALTH FOR MOTHERS FACING TRANSPORTATION OR RESOURCE CHALLENGES. NEONATAL FOLLOW-UP APPOINTMENTS CAN CONVERT TO TELEHEALTH IF NEEDED. ADDITIONAL OPTIONS EXTEND TO FAMILIES FAR FROM CLINIC RESOURCES AND THOSE WITH FEEDING ISSUES. GOOD SAMARITAN START TRAINING SUPPORTS FAMILIES WITH SUD HISTORY. ADDITIONALLY IN 2022, MULTICARE COMPILED A COMMUNITY RESOURCES LIST FOR FOOD INSECURITY, DOMESTIC VIOLENCE, AND MATERNAL MENTAL HEALTH. EDINBURGH POSTNATAL DEPRESSION SCALE WAS INTEGRATED INTO APPOINTMENTS FOR CHILDREN UP TO 12 MONTHS, IN MULTIPLE LANGUAGES. ADDITIONALLY, THERE WAS A PILOT FOR INFANT/EARLY CHILDHOOD MENTAL HEALTH SERVICES IN PARTNERSHIP WITH NAVOS. IN 2022, MULTICARE UPDATED EVIDENCE-BASED RESOURCES FOCUS ON CHILD SAFETY, MULTILINGUAL MATERIALS INCLUDED, COORDINATED WITH EARLY INTERVENTION FOR SMOOTH CARE TRANSITIONS, AND ENHANCED PROVIDER AWARENESS AND REFERRAL PROCESSES WITH WIC. ADDITIONALLY, REACH OUT AND READ BOOKS ORDERED IN PRIMARY HEART LANGUAGES, AND CONVERSATIONS EXPLORE FAMILY RESOURCES IN SCHOOLS FOR MATERNAL/CHILD HEALTH INITIATIVES.OBESITY & PHYSICAL HEALTH - MULTICARE'S EMPOWERING PREGNANCY AND MOTHERHOOD PROGRAM HAD OVER 2100 REFERRALS IN 2022 AND PROVIDED PRE AND POSTNATAL NUTRITION AND HEALTHY LIVING EDUCATION TO WOMEN. MHS'S SNAP - ED PROGRAM ALSO PROVIDED NUTRITION AND HEALTH LIVING EDUCATION IN MIDDLE AND HIGH SCHOOL. THROUGH MHS'S YMCA PARTNERSHIP WE OFFERED INCREASED ACCESS TO WEIGHT-SUPPORTIVE AND CHRONIC DISEASE PREVENTION PROGRAMMING, SUCH AS THE YMCA DIABETES PREVENTION PROGRAM AND THE YMCA WEIGHT LOSS. IN 2022, 278 PATIENTS WERE REFERRED TO YMCA SERVICES.YOUTH OBESITY- IN 2022, WE REFRESHED THE READY, SET, GO 5210 HEALTH MESSAGING CAMPAIGN TO 5 KEYS TO FEEDING WELL WHICH SUPPORTS CURRENT RESEARCH IN EFFECTIVELY ADDRESSING CHILD WEIGHT AND WELLNESS. WE PROVIDED WEIGHT-INCLUSIVE CARE TRAINING TO SUPPORT CHILD HEALTH TO 237 PROVIDERS. WE DEVELOPED AND BEGAN PROVIDING COMMUNITY CLASSES FOR CAREGIVERS AND PARENTS TO IMPROVE CHILD HEALTH. THROUGH OUR SUMMER MEALS PROGRAM, WE PROVIDED 2300 FREE MEALS TO FAMILIES. MARY BRIDGE CHILDREN'S HOSPITAL CONTINUES TO REFER TO THE YMCA ACT! (ACTIVELY CHANGING TOGETHER) PROGRAM. IN 2022, MULTICARE APPLIED FOR AND RECEIVED THE SNAP-ED GRANT TO CONTINUE YOUTH OBESITY RELATED PROGRAMS.ORAL HEALTH (POVERTY)- IN 2022 MHS CONTINUED TO PROVIDE FLUORIDE VARNISHING IN SPOKANE. GROUP A-FACILITY 1 -- TG,GSH,AUB,ALLEN,MB,DEAC,VALLEY,COV,CAPM PART V, SECTION B, LINE 16J: MULTICARE'S TACOMA GENERAL, GOOD SAMARITAN, AUBURN, ALLENMORE, MARY BRIDGE, DEACONESS, VALLEY, COVINGTON AND CAPITAL MEDICAL CENTER HOSPITALS:THE POLICY IS POSTED ON THE WA STATE - DEPARTMENT OF HEALTH WEBSITE. THE HOSPITAL'S BILLING INVOICES INCLUDE REFERENCES TO WHERE AND HOW TO CONTACT SOMEONE TO OBTAIN A COPY OF THE FINANCIAL ASSISTANCE POLICY.PART V, SECTION B, LINE 16 - SUPPLEMENTAL INFORMATION:MULTICARE HEALTH SYSTEM HAS TRANSLATED ITS FA POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY INTO THE PRIMARY LANGUAGES SPOKEN BY LIMITED ENGLISH PROFICIENCY POPULATIONS. PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. 101 1 - COVINGTON AMBULATORY SURGERY CENTER &UCC 17700 SE 272 STREET COVINGTON WA 98042 OP SURGERY, RX, LAB, URGENT CARE 2 - KENT CLINIC 222 STATE AVE NORTH KENT WA 98031 FAMILY MEDICINE 3 - GIG HARBOR MEDICAL PARK & UCC 4545 POINT FOSDICK DRIVE GIG HARBOR WA 98335 OP SURG,RX,LAB,ONCOLOGY,URGENT CARE 4 - AUBURN IMAGING & URGENT CARE CENTER 202 CROSS STREET SE AUBURN WA 98001 IMAGING, URGENT CARE 5 - AUBURN VASCULAR LAB 202 N DIVISION ST SUITE 300-301 AUBURN WA 98001 VASCULAR LAB 6 - TACOMA FAMILY MEDICINE 521 MARTIN LUTHER KING JR WAY TACOMA WA 98405 OP PHYSICIAN CLINIC 7 - OBSTETRICS ACCESS CLINIC 522 MARTIN LUTHER KING JR WAY TACOMA WA 98405 OP PHYSICIAN CLINIC 8 - MULTICARE OBGYN ASSOCIATES 523 MARTIN LUTHER KING JR WAY TACOMA WA 98405 OP PHYSICIAN CLINIC 9 - PODIATRY CLINIC 524 MARTIN LUTHER KING JR WAY TACOMA WA 98405 OP PHYSICIAN CLINIC 10 - MATERNAL FETAL MEDICINE 524 MARTIN LUTHER KING JR WAY TACOMA WA 98405 OP PHYSICIAN CLINIC 11 - SILVERDALE CLINIC 1780 NW MYRTLE RD SUITE G220 SILVERDALE WA 98383 OP PHYSICIAN CLINIC 12 - OLYMPIA CLINIC 200 LILLY ROAD NE BUILDING C OLYMPIA WA 98506 OP PHYSICIAN CLINIC 13 - PUYALLUP CLINIC 1803 SOUTH MERIDIAN SUITE B PUYALLUP WA 98371 OP PHYSICIAN CLINIC 14 - CHILDREN'S THERAPY UNIT 402 15TH AVE SE PUYALLUP WA 98372 OUTPATIENT CHILDREN'S THERAPY UNIT 15 - HEALTH RESOURCE CENTER 2622 S MERIDIAN PUYALLUP WA 98372 OP PHYSICIAN CLINIC 16 - CARDIAC REHABILITATION CENTER 16515 MERIDIAN E SUITE 200B PUYALLUP WA 98372 CARDIAC REHABILITATION 17 - PET-CT CLINIC 400 15TH AVE SE PUYALLUP WA 98372 IMAGING TESTING FACILITY 18 - MULTICARE REGIONAL CANCER CENTER AUBURN 121 N DIVISION ST STE 100 AUBURN WA 98001 OP PHYSICIAN CLINIC 19 - MARY BRIDGE WOMAN'S & CHILDREN'S CLINIC 3504 12TH AVE NW OLYMPIA WA 98506 OP PHYSICIAN CLINIC 20 - MULTICARE ORTHO&SPORTS MEDICINE MOUNTAIN 1550 S UNION AVE STE 210 TACOMA WA 98405 OP SURG,RX,LAB, CHIRO 21 - MULTICARE WEST TACOMA CLINIC & UCC 2209 N PEARL ST STE 100 TACOMA WA 98406 OP SURG,RX,LAB, CHIRO 22 - MULTICARE FREDERICKSON CLINIC 5612 176TH STREET FEDERAL WAY WA 98375 PRIMARY CARE PRACTICE 23 - MULTICARE KENT UCC & HEALTHWORKS 222 STATE AVE N KENT WA 98030 URGENT CARE CLINIC AND OCC MEDICINE 24 - MULTICARE LAKEWOOD UCC & HEALTHWORKS 5700 100TH ST SW LAKEWOOD WA 98499 URGENT CARE CLINIC AND OCC MEDICINE 25 - MULTICARE SPANAWAY URGENT CARE 225 176TH ST S SPANAWAY WA 98387 URGENT CARE CLINIC 26 - MULTICARE UNIVERSITY PLACE URGENT CARE 4310 BRIDGEPORT WAY W UNIVERSITY PLACE WA 98466 URGENT CARE CLINIC 27 - MARY BRIDGE PED OUTPATIENT-GIG HARBOR 4700 PT FOSDICK DR NW GIG HARBOR WA 98335 URGENT CARE CLINIC 28 - MARY BRIDGE PED OUTPATIENT-OLYMPIA 3504 12TH AVENUE NE OLYMPIA WA 98506 URGENT CARE CLINIC 29 - MULTICARE MAPLE VALLEY CLINIC 24080 SE KENT KANGLEY ROAD MAPLE VALLEY WA 98038 OP PHYSICIAN CLINIC 30 - MULTICARE EATONVILLE FAMILY PRACTICE 118 WASHINGTON AVE N EATONVILLE WA 98328 OP PHYSICIAN CLINIC 31 - MULTICARE ORTHOPEDIC SPINE AND HAND 1450 5TH ST SE STE 4200 PUYALLUP WA 98372 OP SURG,RX,LAB, CHIRO 32 - MULTICARE ORTHOPEDICS & SPORTS AUBURN 121 N DIVISION ST STE 310 AUBURN WA 98001 OP SURG,RX,LAB, CHIRO 33 - MULTICARE HEALTHWORKS KENT 6719 S 211TH AT STE 102 KENT WA 98032 OCCUPATIONAL MEDICINE CLINIC 34 - MULTICARE HEALTHWORKS FIFE 502 54TH AVE E FIFE WA 98424 OCCUPATIONAL MEDICINE CLINIC 35 - MULTICARE HEALTHWORKS TACOMA 3124 S 19TH ST TACOMA WA 98405 OCCUPATIONAL MEDICINE CLINIC 36 - MULTICARE GOOD SAMARITAN CANCER CENTER 1519 4TH ST SE PUYALLUP WA 98371 OP SURG,RX,LAB,ONCOLOGY,URGENT CARE 37 - MULTICARE BONNEY LAKE WIC CLINIC 10004 204TH AVE SE BONNEY LAKE WA 98391 WOMEN,INFANT,CHILD CLINIC 38 - MULTICARE INDIGO TACOMA 1812 S MILDRED ST STE H TACOMA WA 98465 URGENT CARE CLINIC 39 - MULTICARE INDIGO TUKWILLA 17275 SOUTHCENTER PKWY STE 160 TUKWILLA WA 98188 URGENT CARE CLINIC 40 - MULTICARE INDIGO MILL CREEK 800 164TH ST SE STE P MILL CREEK WA 98012 URGENT CARE CLINIC 41 - MULTICARE INDIGO SEATTLE 118 NE 45TH ST SUITE A SEATTLE WA 98105 URGENT CARE CLINIC 42 - MULTICARE INDIGO BOTHELL 24118 BOTHELL EVERETT HWY BUILDING E SU BOTHELL WA 98021 URGENT CARE CLINIC 43 - MULTICARE INDIGO ISSAQUAH 6140 E LAKE SAMMAMISH PKWY SE SUITE F ISSAQUAH WA 98029 URGENT CARE CLINIC 44 - MULTICARE INDIGO COVINGTON 27111 167TH PL SE SUITES 101 103 105 COVINGTON WA 98042 URGENT CARE CLINIC 45 - MULTICARE INDIGO LAKE STEVENS 809 VERNON RD LAKE STEVENS WA 98258 URGENT CARE CLINIC 46 - MULTICARE INDIGO OLYMPIA 345 COOPER POINT RD NW STE 10 OLYMPIA WA 98502 URGENT CARE CLINIC 47 - MULTICARE INDIGO PUYALLUP 15125 MERIDIAN AVE E STE 101 PUYALLUP WA 98375 URGENT CARE CLINIC 48 - MULTICARE INDIGO KIRKLAND 12475 TOTEM LAKE BLVD NE KIRKLAND WA 98034 URGENT CARE CLINIC 49 - MULTICARE INDIGO LACEY 5128 YELM HWY D5128 STE DF LACEY WA 98503 URGENT CARE CLINIC 50 - MULTICARE INDIGO RAINIER 3820 RAINIER AVE S SEATTLE WA 98118 URGENT CARE CLINIC 51 - MULTICARE INDIGO POINT RUSTON 5005 RUSTON WAY TACOMA WA 98407 URGENT CARE CLINIC 52 - MULTICARE INDIGO FEDERAL WAY 31861 GATEWAY CENTER BLVD S FEDERAL WAY WA 98003 URGENT CARE CLINIC 53 - MULTICARE INDIGO SOUTH HILL 4911 SOUTH REGAL STREET SPOKANE WA 99223 URGENT CARE CLINIC 54 - MULTICARE INDIGO SPOKANE VALLEY 15605 E SPRAGUE AVE SPOKANE WA 99223 URGENT CARE CLINIC 55 - MULTICARE INDIGO NORTH SPOKANE 9420 NORTH NEWPART HWY SPOKANE WA 99218 URGENT CARE CLINIC 56 - MULTICARE ROCKWOOD URGENT CARE DOWNTOWN 400 E 5TH AVE SPOKANE WA 99202 URGENT CARE CLINIC 57 - CONVENIENCE CARE BY WOODCREECK PEDIATRIC 1706 S MERIDIAN PUYALLUP WA 98371 URGENT CARE CLINIC 58 - CONVENIENCE CARE BY WOODCREECK PEDIATRIC 11102 SUNRISE BLVD PUYALLUP WA 98374 URGENT CARE CLINIC 59 - MULTICARE PUYALLUP URGENT CARE 220 15TH AVE SE PUYALLUP WA 98372 URGENT CARE CLINIC 60 - MULTICARE ROCKWOOD CHENEY 19 NORTH STREET CHENEY WA 99004 PRIMARY CARE PRACTICE 61 - MULTICARE ROCKWOOD DEER PARK 20 E J ST DEER PARK WA 99006 PRIMARY CARE PRACTICE 62 - MULTICARE ROCKWOOD LIBERTY LAKE 1326 N STANFORD LIBERTY LAKE WA 99019 PRIMARY CARE PRACTICE 63 - MULTICARE ROCKWOOD MEDICAL LAKE 725 N STANLEY ST MEDICAL LAKE WA 99022 PRIMARY CARE PRACTICE 64 - MULTICARE ROCKWOOD NORTHPOINTE 605 E HOLLAND STREET SPOKANE WA 99218 PRIMARY CARE PRACTICE 65 - MULTICARE ROCKWOOD PRAIRIE FAMILY MED 3016 E 57TH AVE SPOKANE WA 99223 PRIMARY CARE PRACTICE 66 - MULTICARE ROCKWOOD QUAIL RUN CLINIC 2214 E 29TH AVE SPOKANE WA 99203 PRIMARY CARE PRACTICE 67 - MULTICARE ROCKWOOD SOUTH VALLEY CLINIC 13221 E 32ND AVE SPOKANE WA 99216 PRIMARY CARE PRACTICE 68 - MULTICARE SUMNER ASSOCIATES 5814 GRAHAM AVE SUMNER WA 98390 PRIMARY CARE PRACTICE 69 - MULTICARE ROCKWOOD VALLEY CLINIC 14408 E SPRAGUE AVE SPOKANE VALLEY WA 99216 PRIMARY CARE PRACTICE 70 - OLYMPIC SPORTS AND SPINE LLC 6050 TACOMA MALL BLVD TACOMA WA 98409 PHYSICAL AND OCCUPATIONAL THERAPY 71 - AUBURN IMAGING PARTNERS 125 3RD STREET AUBURN WA 98002 IMAGING TESTING FACILITY 72 - VP SURGERY OF AUBURN 1002 15TH AVE SW AUBURN WA 98001 OP SURG,RX,LAB, CHIRO 73 - REDICLINIC OF WA LLC 9 E GREENWAY PLAZA STE 2950 HOUSTON TX 77046 PHARMACY AND PRIMARY CARE 74 - MULTICARE INDIGO MAPPLE VALLEY 26380 238TH LN SE SUITE 100 MAPLE VALLEY WA 98038 URGENT CARE CLINIC 75 - MULTICARE INDIGO MARYSVILLE 3822 116TH ST NE MARYSVILLE WA 98271 URGENT CARE CLINIC 76 - MULTICARE INDIGO TUMWATER 704 TROSPER RD SW 118 TUMWATER WA 98512 URGENT CARE CLINIC 77 - MULTICARE CENTER FOR WEIGHT LOSS 408 LILLY ROAD NE OLYMPIA WA 98506 WEIGHT LOSS AND WELLNESS 78 - MULTICARE FAMILY MEDICINE -CANYON ROAD 11025 CANYON RD E STE A PUYALLUP WA 98373 FAMILY MEDICINE 79 - MULTICARE CENTER FOR WEIGHT LOSS 2202 S CEDAR STREET TACOMA WA 98405 WEIGHT LOSS AND WELLNESS 80 - MULTICARE DBA LABS NORTHWEST 34618 11TH PL ST STE 100 FEDERAL WAY WA 98003 IMAGING TESTING FACILITY 81 - MULTICARE BONNEY LAKE EMERGENCY CLINIC 9550 195TH AVE E BONNEY LAKE WA 98391 URGENT CARE CLINIC 82 - MULTICARE INDIGO FREDERICKSON 5314 176TH ST E STE 104-106 TACOMA WA 98446 URGENT CARE CLINIC 83 - MULTICARE INDIGO ORTING 215 WHITESELL ST NW ORTING WA 98360 URGENT CARE CLINIC 84 - MULTICARE INDIGO LAKELAND COMMONS 7096 LAKELAND HILLS WAY SE STE 103 AUBURN WA 98092 URGENT CARE CLINIC 85 - MULTICARE INDIGO LIBERTY LAKE 1429 N LIBERTY LAKE RD STE B LIBERTY LAKE WA 99019 URGENT CARE CLINIC 86 - MULTICARE INDIGO BONNEY LAKE 21186 STATE ROUTE 410 E BONNEY LAKE WA 98391 URGENT CARE CLINIC 87 - MULTICARE PULSE HEART INSTITUTE 100 3RD ST DAVENPORT WA 99122 CARDIAC SERVICES 88 - MULTICARE PULSE HEART INSTITUTE 905 E D ST DEER PARK WA 99066 CARDIAC SERVICES 89 - MULTICARE PULSE HEART INSTITUTE 411 FORTUYN RD GRAND COULEE WA 99133 CARDIAC SERVICES 90 - MULTICARE PULSE HEART INSTITUTE 55 W TIETAN ST WALLA WALLA WA 99362 CARDIAC SERVICES 91 - HARBOR PEDIATRICS MARY BRIDGE CHILDREN'S 4700 POINT FOSDICK DR NW GIG HARBOR WA 98335 OUTPATIENT CHILDREN'S HEALTH SERVICES 92 - MULTICARE TACGEN EMERGENCY-FEDERAL WAY 29805 PACIFIC HWY S FEDERAL WAY WA 98003 URGENT CARE CLINIC 93 - MC INDIGO -AIRWAY HEIGHTS 9746 W US HIGHWAY 2 STE C D SPOKANE WA 99224 URGENT CARE CLINIC 94 - MC INDIGO -GIG HARBOR NORTH 4784 BORDEN BLVD STE G GIG HARBOR WA 98332 URGENT CARE CLINIC 95 - WESTERN WASHINGTON CARDIOLOGY SILVERLAKE 12728 19TH AVE SE STE 200 EVERETT WA 98208 CARDIAC SERVICES 96 - WESTERN WASHINGTON CARDIOLOGY MONROE SAT 4841 179TH AVE SE STE 220 MONROE WA 98272 CARDIAC SERVICES 97 - WESTERN WASHINGTON CARDIOLOGY MARYSVILLE 4225 HOYT AVE STE C EVERETT WA 98203 CARDIAC SERVICES 98 - WESTERN WASHINGTON CARDIOLOGY MARYSVILLE 4404 80TH ST NE MARYSVILLE WA 98271 CARDIAC SERVICES 99 - WESTERN WASHINGTON CARDIOLOGY ARLINGTON 875 WESLEY ST STE 110 ARLINGTON WA 98223 CARDIAC SERVICES 100 - CAPITAL MEDICAL CENTER PHYSICIANS LLC 3900 CAPITAL MALL DR SW OLYMPIA WA 98502 FAMILY MEDICINE 101 - CAPITAL MEDICAL CTR SPECIALTY PHYSICIANS 3900 CAPITAL MALL DR SW OLYMPIA WA 98502 SPECIALTY AND FAMILY MEDICINE PART I, LINE 3C: PATIENTS MAY BE DETERMINED AS PRESUMPTIVELY ELIGIBLE FOR CHARITY IF THEY QUALIFY FOR MEDICAID OR IF THEY ARE HOMELESS. PART I, LINE 7: THE AMOUNTS ARE CALCULATED BASED ON A COST-TO-CHARGE RATIO WHICH WAS CALCULATED BASED ON WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: NONE OF THE SUBSIDIZED HEALTH SERVICES INCLUDE COSTS ASSOCIATED WITH PHYSICIAN CLINICS. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBTS THAT WERE EXCLUDED FROM THE TOTAL EXPENSES WHEN CALCULATING THE PERCENTAGE IN COLUMN (F) WAS $107,408,619.PART III, SECTION A, LINE 2, COSTING METHODOLOGY:THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.3-4. PART III, SECTION A, LINE 3, RATIONALE FOR BAD DEBT AMOUNT ATTRIBUTABLE TO COMMUNITY BENEFIT:IT IS OUR BELIEF THAT $3,197,000 OF BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF THE ABILITY TO PAY FOR THAT CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS A COMMUNITY BENEFIT. AS PART OF OUR COMMUNITY NEEDS ASSESSMENT, WE STUDIED THE INCOME CHARACTERISTICS OF THE UNINSURED POPULATION IN OUR COMMUNITY. AS PART OF THIS STUDY, WE ALSO LOOKED AT WHAT PORTION OF UNINSURED INDIVIDUALS IN THE HOSPITAL'S SERVICE AREA WOULD BE ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. WE APPLIED THIS PERCENTAGE TO OUR TOTAL AMOUNT OF BAD DEBT EXPENSE RECORDED TO ESTIMATE THE PORTION OF SELF-PAY BAD DEBT THAT WAS REASONABLY ATTRIBUTABLE TO INDIVIDUALS ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BUT NOT PREVIOUSLY RECORDED AS SUCH. WE SUBTRACTED THE ACTUAL AMOUNT OF FINANCIAL ASSISTANCE RECORDED FROM THIS CALCULATED FIGURE. THE RESULT IS OUR ESTIMATE OF THE AMOUNT THAT SHOULD BE CONSIDERED COMMUNITY BENEFIT COST AND IS ENTERED ON PART III, LINE 3. PART II, COMMUNITY BUILDING ACTIVITIES: MULTICARE HEALTH SYSTEM ACTIVELY PARTICIPATES IN NUMEROUS COMMUNITY BUILDING ACTIVITIES. THEIR EMPLOYEES VOLUNTEER IN VARIOUS PROGRAMS SUCH AS THE AMERICAN RED CROSS, PIERCE COUNTY DIABETES COALITION, UNITED WAY, AMERICAN HEART ASSOCIATION, MARCH OF DIMES, COMMUNITIES IN SCHOOLS, HABITAT FOR HUMANITY, SAFE STREETS COALITION, YWCA (PROVIDING A DOMESTIC VIOLENCE SHELTER FOR WOMEN AND CHILDREN), AMERICAN CANCER SOCIETY, AND OTHER ORGANIZATIONS.THE FOLLOWING ACTIVITIES BY REGION, AVAILABLE TO ALL COMMUNITY MEMBERS, PROVIDE OPPORTUNITIES FOR IMPROVED PHYSICAL, MENTAL, AND EMOTIONAL HEALTH:A) INLAND NORTHWEST REGION:- DOMESTIC VIOLENCE AND ADVOCACY SERVICES AND RESOURCE ASSISTANCE IN COLLABORATION WITH THE YWCA;- SPOKANE REGIONAL DOMESTIC VIOLENCE COALITION;- BETTERHEALTHTOGETHER (ACH) LEARNING COLLABORATIVES & FREE TRAINING SESSIONS;- WASHINGTON PEER ALLIANCE COALITION; - NATIONAL INSTITUTE FOR MENTAL ILLNESS EDUCATION AND SPEAKING SERIES; - RECOVERY CAF EDUCATION AND VIRTUAL WORKSHOP SERIES; - A BEHAVIORAL PROGRAM IN PARTNERSHIP WITH PIONEER HUMAN SERVICES AND CORAM INFUSION, HELPING PATIENTS WITH LONG-TERM IV DRUG USE RECEIVE SUBSTANCE USE DISORDER ASSESSMENTS AND INPATIENT TREATMENT, PEER COUNSELING SERVICES, AND BEHAVIORAL HEALTH TREATMENT;- DEACONESS MENTAL HEALTH ASSOCIATES, A PROGRAM THAT HIRED AND TRAINED SPECIALISTS TO IMPROVE THE CARE OF BEHAVIORAL HEALTH PATIENTS IN THE EMERGENCY DEPARTMENT; - SPOKANE REGIONAL EMERGENCY COMMAND CENTER BEHAVIORAL HEALTH TASK FORCE;- GRANT-FUNDED PROGRAM NAMED "BETTERHEALTH THROUGH HOUSING PROVIDENCE", IN COLLABORATION WITH BETTERHEALTHTOGETHER, SNAP, SPOKANE HOUSING AUTHORITY, CHPW, AND MOLINA;- A PROGRAM TO HELP CHRONICALLY HOMELESS PATIENTS WITH BEHAVIORAL HEALTH AND SUBSTANCE USE NEEDS GET INTO STABLE HOUSING AFTER 4 EMERGENCY DEPARTMENT VISITS IN 6 MONTHS; - SEXUAL ASSAULT NURSE EXAMINERS (SANE NURSES) AVAILABLE TO PATIENTS IN THE HOSPITALS AND ED;- QUARTET, AN ONLINE WEB-BASED PORTAL TO IMPROVE THE COORDINATION OF BEHAVIORAL HEALTH REFERRALS, ENSURING PATIENTS HAVE MORE TIMELY ACCESS TO BEHAVIORAL HEALTH CARE WITHIN THE COMMUNITY; - EAT, SLEEP AND CONSOLE PROGRAM ADDRESSING BABIES BEING BORN WITH DRUG ADDICTION SYMPTOMS;- HOUSE OF CHARITY RESPITE CARE FOR HOMELESS AND COLLABORATION WITH CATHOLIC CHARITIES OF E. WA; -PREVENT SUICIDE SPOKANE COALITION;- REGIONAL EMERGENCY & DISASTER HEALTHCARE CORRELATION LEADERSHIP PARTICIPATION AND CENTRAL COMMAND CENTER;- SPOKANE REGIONAL OPIOID TASK FORCE;-END THE VIOLENCE CAMPAIGN;- "SMILE SPOKANE LEADERSHIP IMPACT NETWORK PARTICIPATING MEMBER" TO IMPROVE ORAL HEALTH CARE IN EDUCATION IN SPOKANE COUNTY; -UNDERSERVED ELEMENTARY AND MIDDLE SCHOOL STUDENT OUTREACH PROGRAMS WITH PINES MIDDLE SCHOOL, BROADWAY ELEMENTARY AND REGAL ELEMENTARY, PROVIDING SCHOOL SUPPLIES, SCIENCE EDUCATION AND WINTER CLOTHING;- ANNUAL TREE OF GIVING;- SPOKANE VALLEY PARTNERS COLLABORATION SUPPORTING THE FOOD BANK, CLOTHING BANK, EMERGENCY ASSISTANCE, FOOD4THOUGHT PROGRAM, FOOD EXPRESS, INLAND NW BABY DIAPER BANK, CAREER CLOTHING BANK AND A SUMMER FOOD DRIVE;- ANNUAL BRIDGE TO BRUNCH COMMUNITY 5K RUN/WALK PROVIDED BY MULTICARE AS A COMMUNITY EVENT SUPPORTING AND RAISING AWARENESS FOR A COMMUNITY CANCER FUND; -CLINICAL, EMOTIONAL AND FINANCIAL ONGOING SUPPORT OF FREEMAN HIGH SCHOOL STUDENTS, STAFF AND FAMILIES FOLLOWING THE 2017 SHOOTING;- HOOPFEST, PROVIDING 2 - DAYS OF MEDICAL AND VOLUNTEER SUPPORT FOR 6000 TEAMS AND 225,000 FANS;- AMERICAN HEART AND STROKE WALK AND ANNUAL FUNDRAISING SUPPORT CAMPAIGN;OPERATING HEALTHY FAMILY PARTNERSHIP FOR ORAL HEALTH EDUCATION & LINK TO DENTAL CARE;- BIG TABLE PARTNERSHIP FROM ORAL HEALTH;- WSU HEALTHY PEOPLE HEALTHY PETS PARTNERSHIP TO PROVIDE VACCINATIONS TO HOMELESS AND LOW-INCOME INDIVIDUALS AND THEIR PETS;- "ACCOUNTABLE COMMUNITY OF HEALTH PARTNER" FOR IMPROVING ACCESS TO CARE FOR LOW-INCOME MEDICAID POPULATION IN BEHAVIORAL HEALTH, OPIOID USE, CHRONIC DISEASE MANAGEMENT, ORAL HEALTH AND HEALTH EQUITY;- TELEPSYCH SERVICES FOR ED/INPATIENT CARE;- OUT OF THE DARKNESS WALK FOR SUICIDE PREVENTION;- SECOND HARVEST'S TOM'S TURKEY DRIVE PROVIDING LOCAL FAMILIES WITH THANKSGIVING MEALS;- PARTNERSHIP WITH FREEMAN SCHOOLS SCOTTY DASH TO SUPPORT ACADEMIC, SPORT, EXTRACURRICULAR AND FACILITY NEEDS;- FAMILY PROMISE OF SPOKANE HOMELESS SHELTER PROVIDED SAFETY EQUIPMENT TO HELP REMODEL THEIR NEW AND LARGER SHELTER;- MULTICARE DEACONESS HOSPITAL RONALD MCDONALD FAMILY ROOMS PROVIDED FOR ANY FAMILIES WITH CHILDREN IN THE HOSPITAL.B) PUGET SOUND:- TACOMA TRAUMA TRUST IS A COLLABORATION OF MULTICARE, FRANCISCAN HEALTH SYSTEM AND MADIGAN ARMY MEDICAL CENTER TO PROVIDE TRAUMA CARE TO THE SOUTH PUGET SOUND REGION;- FALLS PREVENTION PROGRAM FOR THE ELDERLY;- SEXUAL ASSAULT PREVENTION PROGRAM IN THE FORENSIC NURSE EXAMINER PROGRAM, PROVIDING CARE TO ADULT VICTIMS OF SEXUAL ASSAULT;- BEHAVIORAL HEALTH CRISIS INTERVENTION PROGRAM;- MARY BRIDGE CENTER FOR CHILDHOOD SAFETY AND THE MARY BRIDGE CHILDREN'S ADVOCACY CENTER;- BRIDGES: A CENTER FOR GRIEVING CHILDREN;- SCHOOL BASED HEALTH PROGRAM;- HOME HEALTH, HOSPICE AND PALLIATIVE CARE SERVICES;- GRIEF AND LOSS SERVICES;- FAMILY CAMP ERIN FOR CHILDREN SUFFERING LOSSES OF FAMILY MEMBERS;- CANCER CAMP FOR CHILDREN WITH CANCER;- WOMAN, INFANTS AND CHILDREN (WIC) PROGRAM;- SAFE KIDS;- SAFE SHORES;- THE CENTER FOR HEALTH EQUITY & WELLNESS NUTRITION AND FITNESS EDUCATION, WEIGHT MANAGEMENT, TOBACCO CESSATION AND COMMUNITY HEALTH IMPROVEMENT PROGRAMS:- PUGET SOUND ASTHMA COALITION;- DIABETES SERVICES;- CONSULTING NURSE TELEPHONE SERVICE;- CHRONIC DISEASE MANAGEMENT SUPPORT GROUPS. IN 2022 MULTICARE AWARDED NEARLY $40,000 IN SPONSORSHIP SUPPORT TO OUR NON-PROFIT COMMUNITY TO ORGANIZATIONS SUCH AS: BOYS & GIRLS CLUB OF THURSTON COUNTY;SOUTH PUGET SOUND COMMUNITY COLLEGE;FAMILY EDUCATION & SUPPORT SERVICES;SAINT MARTIN'S UNIVERSITY; IN THURSTON COUNTY, MULTICARE AWARDED $700,000 IN CHARITY CARE MONEY TO: FAMILY SUPPORT CENTER;BEHAVIORAL HEALTH RESOURCES; SEAMAR; VALLEY VIEW;UNION GOSPEL MISSION; OLYMPIA FREE CLINIC;FINANCIAL ASSISTANCE IS OFFERED SO THAT NO ELIGIBLE FAMILY IS TURNED AWAY BECAUSE OF INABILITY TO PAY. IN ADDITION, THE COMMUNITY PARTNERSHIP FUND OFFERS FINANCIAL SUPPORT TO COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE HOUSING ASSISTANCE TO HOMELESS INDIVIDUALS, INCLUDING ORGANIZATIONS SUCH AS CATHOLIC COMMUNITY SERVICES, AND THE KOREAN WOMEN'S ASSOCIATION. PART III, LINE 8: COSTING METHODOLOGY:THE SOURCE USED TO CALCULATE THE MEDICARE ALLOWABLE COSTS FOR TACOMA GENERAL, ALLENMORE, GOOD SAMARITAN, AUBURN, COVINGTON, CAPITAL MEDICAL CENTERS AND DEACONESS AND VALLEY HOSPITALS WAS THE 2022 MEDICARE COST REPORTS. SINCE MARY BRIDGE CHILDREN'S HOSPITAL FILES A LOW MEDICARE UTILIZATION COST REPORT, THE PROVIDER STATISTICAL AND REIMBURSEMENT SYSTEM REPORT (PS&R) WAS USED. THE COST TO CHARGE RATIO, AS CALCULATED FROM THE INCOME STATEMENT, WAS APPLIED TO THE PS&R GROSS MEDICARE CHARGES TO CALCULATE THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6. MARY BRIDGE COSTS REPRESENT LESS THAT 0.1% OF THE TOTAL.MEDICARE SHORTFALL TREATED AS COMMUNITY BENEFIT:THE HOSPITAL BELIEVES THAT ALL OF THE $127.3 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 27.05% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B: MULTICARE'S DEBT COLLECTION POLICY STATES THAT "MHS WILL ALSO CLEARLY COMMUNICATE TO PATIENTS AND APPLICABLE PARTIES THE VARIOUS ASSISTANCE PROGRAMS MHS OFFERS BASED ON THE SITE OF SERVICE." IF THE PATIENT FOLLOWS THROUGH WITH THE APPLICABLE ASSISTANCE APPOINTMENTS, I.E., MEETING WITH MEDICAID OR COUNTY AGENCIES TO COMPLETE THE NECESSARY APPLICATION PROCESS, MULTICARE WILL NOT SEND THE ACCOUNT TO A BAD DEBT COLLECTION AGENCY.THERE ARE CIRCUMSTANCES WHERE A PATIENT DOES NOT RESPOND TO MULTICARE'S BILLING STATEMENTS AND IS SENT TO COLLECTIONS. AT THIS POINT, WHEN THEY ARE IN COLLECTIONS, IF THEY REQUEST FINANCIAL ASSISTANCE AND MEET CRITERIA UNDER THE FINANCIAL ASSISTANCE POLICY'S FEDERAL POVERTY GUIDELINES (FPG), THE COLLECTIONS WILL NOT BE PURSUED. PART VI, LINE 2: MULTICARE COLLABORATES WITH REGIONAL AGENCIES AND ORGANIZATIONS TO IDENTIFY THE HEALTHCARE REQUIREMENTS OF THE COMMUNITIES WE SERVE AND TO ESTABLISH PROGRAMS AND SERVICES THAT ADDRESS THOSE NEEDS.MULTICARE PARTNERS WITH VARIOUS COMMUNITY ENTITIES, SUCH AS PUBLIC HEALTH AGENCIES, UNITED WAY AGENCIES, CITY MUNICIPALS, PUBLIC SCHOOLS, COMMUNITY COALITIONS, FEDERALLY QUALIFIED HEALTH CENTERS, YMCA'S, SMILE SPOKANE, AND OTHERS.TO DETERMINE THE MOST CRITICAL HEALTHCARE NEEDS IN ITS SERVICE AREAS, MULTICARE HEALTH SYSTEM UTILIZES DATA FROM ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENT (CHA), AND FEDERAL AND STATE-LEVEL DATA.GIVEN THE COMPREHENSIVENESS OF THE CHNA PROCESS, THE ORGANIZATION DOES NOT CONDUCT ADDITIONAL ASSESSMENTS.FOR MORE DETAILED INFORMATION, SEE PART V, SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION B. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN A VARIETY OF WAYS. FINANCIAL AID INFORMATION IS POSTED ON THE MULTICARE.ORG EXTERNAL WEBSITE.PRE-SERVICE CENTER STAFF STARTS CONVERSATIONS WITH PATIENTS ABOUT THEIR POTENTIAL FINANCIAL RESPONSIBILITY AND SHARE PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE INFORMATION WITH THE PATIENT DURING THIS INITIAL PHONE CALL. AT THE TIME OF REGISTRATION (WHETHER PRE-REGISTERED OR NOT), PATIENTS ARE NOTIFIED ABOUT THEIR INSURANCE COVERAGE AND FINANCIAL LIABILITIES. FINANCIAL COUNSELORS ARE AVAILABLE IF A NEED IS IDENTIFIED. MULTICARE ACTIVELY WORKS TO IDENTIFY PATIENTS WITHOUT INSURANCE AND HELPS CONNECT THESE PATIENTS TO ANY STATE OR FEDERAL RESOURCES, INCLUDING ASSISTING IN APPLYING FOR DIFFERENT HEALTH INSURANCE PLANS. EVEN IF A PATIENT QUALIFIES FOR HEALTH INSURANCE OUR STAFF WILL ALSO SCREEN THEM FOR FINANCIAL ASSISTANCE, IF APPLICABLE. FINANCIAL AID APPLICATIONS ARE HANDED OUT AT ALL SERVICE LOCATIONS UPON REQUEST OR WHEN A NEED IS IDENTIFIED BY STAFF. PATIENTS ARE ALSO GIVEN AN INFORMATIONAL BILLING HANDOUT AT REGISTRATION/ADMISSION WITH INFORMATION TO CONTACT FINANCIAL COUNSELORS IF THEY MAY HAVE DIFFICULTY PAYING THEIR HOSPITAL BILL. FINALLY, ANY MULTICARE BILL SENT TO A PATIENT INCLUDES INFORMATION ABOUT FINANCIAL ASSISTANCE. PART VI, LINE 4: MULTICARE HEALTH SYSTEM IS A WASHINGTON STATE INTEGRATED DELIVERY SYSTEM THAT OPERATES IN TWO REGIONS, THE PUGET SOUND AND THE INLAND NORTHWEST.THE SERVICE AREA FOR THE PUGET SOUND IS DEFINED AS PIERCE, KING, KITSAP AND THURSTON COUNTIES, WHICH INCLUDES THE CITIES OF TACOMA, PUYALLUP, UNIVERSITY PLACE, LAKEWOOD, BONNEY LAKE, GIG HARBOR, AUBURN, KENT, FEDERAL WAY, COVINGTON, OLYMPIA AND SILVERDALE. THERE ARE 12 HOSPITALS IN PIERCE AND SOUTH KING COUNTIES, AND SIX OF THEM ARE MULTICARE HOSPITALS. THE PUGET SOUND REGION'S POPULATION IS 4.3 MILLION.AS PER THE U.S. CENSUS, 71.9% OF PIERCE COUNTY'S POPULATION IDENTIFIES AS WHITE, 8.2% AS AFRICAN AMERICAN, 7.6% AS ASIAN, 1.8% AS NATIVE AMERICAN, 1.8% AS NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER, 12.5% AS HISPANIC OR LATINO, AND 9.1% AS SOME OTHER RACE OR TWO OR MORE RACES. THE COUNTY HAS AN 8.7% POVERTY RATE, WITH A MEDIAN HOUSEHOLD INCOME OF $76,438. ADDITIONALLY, 7.4% OF THE POPULATION LACKS HEALTH INSURANCE. AS FOR KING COUNTY, THE TOTAL POPULATION IS 2,296,675 AND THE MEDIAN HOUSEHOLD INCOME IS $110,586. ABOUT 7.6% OF INDIVIDUALS IN THE COUNTY ARE LIVING IN POVERTY. COMPARABLY, IN THURSTON COUNTY, THERE ARE 297,977 INDIVIDUALS. THE PRIMARY SERVICE AREA FOR THE INLAND NORTHWEST REGION IS DEFINED AS SPOKANE WHICH INCLUDES THE CITIES OF SPOKANE, SPOKANE VALLEY, CHENEY, MEDICAL LAKE, AIRWAY HEIGHTS, AND LIBERTY LAKE. THE SECONDARY SERVICE AREA IS DEFINED AS ADAMS, LINCOLN, PEND ORIELLE, STEVENS, AND WHITMAN COUNTIES. THERE ARE SEVEN HOSPITALS IN TOTAL IN SPOKANE COUNTY, AND TWO OUT OF THEM ARE MULTICARE HOSPITALS. THE US CENSUS STATES THAT SPOKANE COUNTY'S POPULATION IS 88.9% WHITE, 2.0% BLACK, 1.8% NATIVE AMERICAN, 2.2% ASIAN, 0.2 % ARE NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER, 4.8% ARE TWO OR MORE RACES, AND 6.1% ARE HISPANIC OR LATINO. THE TOTAL POPULATION OF SPOKANE COUNTY IS 549,690 AND THE MEDIAN HOUSEHOLD INCOME IS $76,438. THE U.S CENSUS BUREAU REPORTS THAT 7.0% OF THE SPOKANE COUNTY POPULATION IS UNINSURED. MULTICARE HEALTH SYSTEM INCLUDES A LARGE NETWORK OF PRIMARY AND SPECIALTY PROVIDERS AND IS LICENSED FOR 1,909 BEDS AND OPERATES SEVERAL OUTPATIENT SURGICAL SITES IN OTHER URGENT CARE, PRIMARY CARE, AND MULTISPECIALTY CLINICS. MULTICARE HEALTH SYSTEM PROVIDES SERVICES DESIGNED TO MEET THE SPECIFIC HEALTHCARE REQUIREMENTS OF THE POPULATION, WITH A COMPREHENSIVE ARRAY OF INPATIENT AND OUTPATIENT PROGRAMS MADE AVAILABLE IN CONJUNCTION WITH THE RESOURCES OF OTHER COMMUNITY HEALTH PROVIDERS. PART VI, LINE 5: MULTICARE HEALTH SYSTEM IS GOVERNED BY A BOARD OF DIRECTORS WHOSE MEMBERS REPRESENT THE COMMUNITY, AND HOSPITAL AND MEDICAL STAFF LEADERSHIP. CONSISTENT WITH THE IRS'S "COMMUNITY BENEFIT STANDARD," A MAJORITY OF THE BOARD OF DIRECTORS ARE NEITHER EMPLOYEES, CONTRACTORS NOR FAMILY MEMBERS OF THE ORGANIZATION. MULTICARE HEALTH SYSTEM HAS AN OPEN MEDICAL STAFF, EXTENDING STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS FOR ALL AREAS AND DEPARTMENTS OF ITS FACILITIES. AS A NOT-FOR-PROFIT ORGANIZATION, SURPLUS FUNDS GENERATED BY HOSPITAL OPERATIONS ARE RE-INVESTED BY THE ORGANIZATION TO FUND CAPITAL IMPROVEMENTS AND ACQUIRE STATE-OF-THE-ART MEDICAL EQUIPMENT WITH THE INTENT OF CONTINUALLY IMPROVING PATIENT CARE. ON AN ANNUAL BASIS STAFF FROM MANY DEPARTMENTS CONDUCT COMMUNITY BENEFIT PROGRAMS AND SERVICES TO CONTINUOUSLY PROVIDE HEALTH EDUCATION, PROMOTION, AND WELLNESS SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY.MULTICARE HEALTH SYSTEM PARTICIPATES IN A WIDE VARIETY OF ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE.IN THE PUGET SOUND REGION, THIS INCLUDES:-BLUE ZONES;FOOD BANK BLOOD PRESURE CHECKS & NUTRITION INFO;TACOMA TRAUMA TRUST, A COLLABORATIVE OF MULTICARE, VIRGINIA MASON FRANCISCAN HEALTH SYSTEM AND MADIGAN ARMY MEDICAL CENTER TO PROVIDE ADULT TRAUMA CARE;FALLS PREVENTION PROGRAM FOR THE ELDERLY;COMMUNITY BASED POP UP COVID VACCINE CLINICS;SEXUAL ASSAULT PREVENTION PROGRAM AND THE FORENSIC NURSE EXAMINER PROGRAM, PROVIDING CARE TO ADULT SEXUAL ASSAULT VICTIMS;BEHAVIORAL HEALTH CRISIS INTERVENTION PROGRAM;MARY BRIDGE CENTER FOR CHILDHOOD SAFETY AND MARY BRIDGE CHILDREN'S ADVOCACY CENTER;BRIDGES: A CENTER FOR GRIEVING CHILDREN;MARY BRIDGE MOBILE IMMUNIZATION CLINIC;HEALTH EQUITY COMMUNITY ADVISORY BOARD;HEALTH EQUITY SPEAKER SERIES;HOME HEALTH, HOSPICE AND PALLIATIVE CARE SERVICES;GRIEF AND LOSS SERVICES;CAMP ERIN FOR CHILDREN SUFFERING LOSSES OF FAMILY MEMBERS;CANCER CAMP FOR CHILDREN WITH CANCER;WOMAN, INFANT AND CHILDREN (WIC) PROGRAM;SAFE SHORES;CENTER FOR HEALTH EQUITY AND WELLNESS NUTRITION AND FITNESS EDUCATION;WEIGHT MANAGEMENT, TOBACCO CESSATION AND COMMUNITY HEALTH IMPROVEMENT PROGRAMS;PUGET SOUND ASTHMA COALITION;DIABETES SERVICES;CHRONIC DISEASE MANAGEMENT SUPPORT GROUPS;WORKFORCE DEVELOPMENT PARTNERSHIP WITH THE PIERCE COUNTY WORKFORCE DEVELOPMENT COUNCIL AND THE PIERCE COUNTY HEALTH CAREERS COUNCIL;PARTNERSHIP WITH AREA COLLEGE NURSING PROGRAMS IN A NURSING RESIDENCY PROGRAM;MASH CAMP, A WEEK-LONG PROGRAM FOR HIGH SCHOOL STUDENTS SEEKING TO EXPLORE NURSING AND ALLIED HEALTH PROFESSIONS;FREE SPORTS PHYSICALS FOR TACOMA SCHOOL DISTRICT STUDENTS;READY, SET, GO! 5210, A COMMUNITY-WIDE PUBLIC-PRIVATE PARTNERSHIP TO PROMOTE HEALTHY LIFESTYLES FOR CHILDREN AND FAMILIES;SIBLING SUPPORT PROJECT TO BENEFIT SIBLINGS OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS;ASSISTIVE TECHNOLOGY PROGRAM PROVIDING ADAPTATIONS TO THE ENVIRONMENT TO IMPROVE INDEPENDENCE;PROJECT ACCESS AND PROJECT NW TO HELP IMPROVE HEALTH OUTCOMES AND REDUCE INAPPROPRIATE EMERGENCY ROOM USE. PROJECT ACCESS ALSO PROVIDES PREMIUM ASSISTANCE FOR PATIENTS. IN THE INLAND NW (EASTERN WA-SPOKANE):BACKPACK AND SCHOOL SUPPLY DRIVE, WITH BOYS AND GIRLS CLUB;PROJECT ACCESS, PROVIDING CHARITABLE CARE FOR THOSE NEEDING PRIMARY AND SPECIALTY CARE SERVICES;SEXUAL ASSAULT PREVENTION PROGRAM AND THE FORENSIC NURSE EXAMINER PROGRAM PROVIDING CARE TO ADULT, ADOLESCENT AND PEDIATRIC SEXUAL ASSAULT VICTIMS;PARTNERING WITH NORTHEAST COMMUNITY CENTER TO RAISE FUNDS AND BEGIN BUILDING A NEW COMMUNITY BEHAVIORAL HEALTH CLINIC IN SPOKANE, OPERATED BY MULTICARE;PARTNERING RELATIONSHIP WITH INW BEHAVIORAL HEALTH HOSPITAL FOR PSYCHIATRIC CARE;AMERICAN BEHAVIORAL HEALTH SERVICES PARTNERSHIP;TUBERCULOSIS TESTING FOR WSU MEDICAL STUDENTS;FLU VACCINATION FOR EWU AND WSU STUDENTS;AMERICAN HEART ASSOCIATION BROWN BAG LUNCH PROVIDER PRESENTATION;TOBACCO CESSATION AND RESOURCES AND EDUCATION FOR PATIENTS AND COMMUNITY MEMBERS IN PARTNERSHIP WITH SPOKANE REGIONAL HEALTH DISTRICT;WSDOT EDUCATIONAL OUTREACH IN SLEEP HEALTH, BODY MECHANICS, WARNING SIGNS, AND RISK DETECTION OF CHRONIC AND ACUTE CONDITIONS OF MAJOR HEALTH PROBLEMS;BREAST HEALTH EVENT TO INCREASE ACCESS TO SCREENING AND RISK AWARENESS EDUCATION;THE PROVISION OF BEHAVIORAL HEALTH SERVICES TO EWU STUDENTS;DOMESTIC VIOLENCE AND RESOURCE AWARENESS TRAINING FOR MULTICARE EMPLOYEES;PIONEER HUMAN SERVICES PARTNERSHIP;JASPR HEALTH PARTNERSHIP FOR IMPROVING THERAPEUTIC CARE OF SUICIDAL PATIENTS IN THE ED.THE HOSPITALS OF THE AFFILIATED GROUP UTILIZE FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY INCLUDING BUT NOT LIMITED TO:EDUCATIONAL PROGRAMS ON TOBACCO CESSATION, HEALTHY AGING, CHILDBIRTH, INFANT CARE, HEALTH AND WELLNESS, AND NUTRITION; FREE MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE LOW-COST IMMUNIZATIONS IN THE COMMUNITY; EXPANSION OF THE EMERGENCY DEPARTMENTS TO ACCOMMODATE AN INCREASE IN EMERGENCY DEPARTMENT PATIENTS; SENIOR MEMBERSHIP AFFINITY PROGRAM; CANCER TRIALS AND RESEARCH; MULTICARE INSTITUTE FOR RESEARCH & INNOVATION; CARE MANAGEMENT, POWER OF ATTORNEY, AND NOTARY SERVICE MEDICATIONS; CHILDREN'S THERAPY UNIT; ASSISTIVE TECHNOLOGY PROGRAM; COMMUNITY EDUCATION: TRANSFUSION FREE MEDICAL & SURGICAL PROGRAM; MULTICARE GOOD SAMARITAN READERS; FAMILY BIRTH CENTER AND CLASSES AND SERVICES; AND MOBILE HEALTH SERVICES, PALLIATIVE CARE, PHYSICAL MEDICINE & REHABILITATION, AND VOLUNTEER SERVICES.INLAND NORTHWEST OFFERINGS & PARTNERSHIPS INCLUDE BUT ARE NOT LIMITED TO:BREASTFEEDING CLASSES;CHILDBIRTH EDUCATION;SAFE INFANT SLEEP;EASTERN WASHINGTON UNIVERSITY, GONZAGA, AND WASHINGTON STATE UNIVERSITY STUDENT PRACTICUM AND PROJECT PLACEMENT;SUMMER GROUP CLASSES FOR TEENAGERS WITH BEHAVIORAL HEALTH NEEDS;GROUP CLASSES FOR ADULTS WITH INSOMNIA OR OTHER SLEEP DISORDERS;EASTERN WASHINGTON UNIVERSITY AND WHITWORTH UNIVERSITY GUEST LECTURES;HEALTH TB TESTING & FLU VACCINATION PROGRAM;ALS CAREGIVERS SUPPORT GROUP;SCLERODERMA SUPPORT GROUP;SPOKANE COUNTY COLLEAGUES AND WASHINGTON STATE UNIVERSITY NURSING;ROUNDING CONFERENCE;EWU STUDENT THERAPY SERVICES;SUBSTANCE USE DISORDER PROGRAM WITH PIONEER HUMAN SERVICES;OUD/MAT TREATMENT PROGRAM UNDER SOR GRANT;OUD/MAT OUTPATIENT TREATMENT PROGRAM UNDER HUB AND SPOKE MODEL;HOUSING PROGRAM WITH BHT AND OTHER PARTNERS FOR CHRONICALLY HOMELESS PATIENTS IN THE ED;THERAPEUTIC SERVICES PARTNERSHIP WITH JASPR HEALTH PILOT FOR SUICIDAL PATIENTS IN THE ED;QUARTET DIGITAL BEHAVIORAL HEALTH REFERRAL COORDINATION IMPLEMENTATION;UNIVERSITY OF WASHINGTON AIMS CENTER PARTNERSHIP IN IMPLEMENTING COLLABORATIVE CARE (INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH) IN THE INW AT ROCKWOOD.SOUTH PERRY FARMER'S MARKET SHARING INFORMATION RELATED TO NEW PROGRAMS TTP PROGRAM, NAR TO NAC, NURSE TECH, MEDICAL ASSISTANT, PHLEBOTOMY, AND OTHER PROGRAMS. COMMUNITY STOP THE BLEED CLASSES AVAILABLE MONTHLY ON THE DEACONESS CAMPUSIN 2022, MULTICARE WAS ABLE TO IMPROVE HEALTH PROMOTION. FOR EXAMPLE, MULTICARE'S 8,287 CHILDHOOD VACCINATIONS IN VARIOUS COMMUNITY SERVICE AREAS. ADDITIONALLY, THE BRIDGES PROGRAM CENTER FOR GRIEVING CHILDREN PROGRAM SERVED 2,600 INDIVIDUALS, WHICH WAS 442 MORE THAN 2021. FURTHERMORE, IN 2022, MULTICARE CONTINUED THE BLUE ZONES PROJECT, WHICH IS DESIGNED TO REDUCE OBESITY, SMOKING AND STRESS, IMPROVE EMPLOYEE AND STUDENT PRODUCTIVITY, AND BOOST ECONOMIC VITALITY IN PIERCE COUNTY WASHINGTON. IN 2015, MHS INTRODUCED THE MULTICARE COMMUNITY PARTNERSHIP FUND. IN 2022, MULTICARE ALLOCATED $600,000 TO SUPPORT COMMUNITY ORGANIZATIONS IN PIERCE, KING, THURSTON, KITSAP COUNTIES, FOCUSING ON IMPROVING RESIDENTS' QUALITY OF LIFE. ADDITIONALLY, THE INLAND REGION GRANTED $250,000 TO EASTERN WA COMMUNITY ORGANIZATIONS ALIGNED WITH MHS'S MISSION OF PARTNERING HEALING AND A HEALTHY FUTURE.MORE INFORMATION ON THE ORGANIZATIONS AWARDED GRANTS IN 2022 CAN BE FOUND AT HTTPS://WWW.MULTICARE.ORG/COMMUNITYPARTNERSHIP/ AND WITHIN MULTICARE'S FORM 990, SCHEDULE I.MULTICARE COLLABORATES WITH VARIOUS COMMUNITY PARTNERSHIP FUND RECIPIENTS TO ENHANCE SERVICES. THEY CURRENTLY WORK WITH COMMUNITIES IN SCHOOLS OF PUYALLUP AND TACOMA TO IMPROVE PHYSICAL AND BEHAVIORAL HEALTH ACCESS FOR STUDENTS. ADDITIONALLY, MULTICARE SUPPORTS THE TEAMS SENIOR PROGRAM IN PIERCE AND KING COUNTIES, PARTNERS WITH KWA FOR THE SBIRT PROGRAM TO ENHANCE BEHAVIORAL HEALTH OUTCOMES, INCLUDING MINORITY BEHAVIORAL HEALTH. THEY ALSO COLLABORATE WITH OASIS YOUTH CENTER, RAINBOW CENTER, AND PCAF TO ENHANCE LGBTQ+ PATIENT EXPERIENCES, AND PROVIDE SUPPORT OPERATIONS AT TRINITY NEIGHBORHOOD HEALTH CLINIC, OFFERING FREE MEDICAL SERVICES. IN THE INLAND NORTHWEST REGION, MULTICARE COLLABORATES WITH CATHOLIC CHARITIES OF EASTERN WASHINGTON'S HOUSE OF CHARITY TO PROVIDE RESPITE CARE FOR THE HOMELESS. PART VI, LINE 6: MULTICARE HEALTH SYSTEM ("MULTICARE") IS A WASHINGTON NOT-FOR-PROFIT CORPORATION AND ORGANIZED AS A TAX-EXEMPT ENTITY UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE OF 1986. MULTICARE HAS TWO AFFILIATED FOUNDATIONS AS FOLLOWS: MULTICARE FOUNDATIONS AND MARY BRIDGE CHILDREN'S FOUNDATION, ALL WASHINGTON NOT-FOR-PROFIT CORPORATIONS.MULTICARE HEALTH SYSTEM HAS 20,000 TEAM MEMBERS, INCLUDING EMPLOYEES, PROVIDERS, AND VOLUNTEERS. MULTICARE HEALTH SYSTEM IS CARING FOR THE COMMUNITY FOR WELL OVER A CENTURY, SINCE THE FOUNDING OF TACOMA'S FIRST HOSPITAL ON APRIL 29, 1882, THE TACOMA GENERAL HOSPITAL, AND TODAY, MULTICARE IS THE LARGEST COMMUNITY-BASED, LOCALLY GOVERNED HEALTH SYSTEM IN THE STATE OF WASHINGTON.MULTICARE'S COMPREHENSIVE SYSTEM OF HEALTH INCLUDES TEN HOSPITALS, NUMEROUS URGENT CARE, PRIMARY CARE, SPECIALTY SERVICES CLINICS, AND VIRTUAL CARE TO NAME A FEW.MULTICARE HEALTH SYSTEM'S HOSPITALS ARE:MULTICARE TACOMA GENERAL HOSPITAL, TACOMA,MULTICARE ALLENMORE HOSPITAL, TACOMA,MARY BRIDGE CHILDREN'S HOSPITAL, TACOMA,MULTICARE GOOD SAMARITAN HOSPITAL, PUYALLUP,MULTICARE AUBURN MEDICAL CENTER, AUBURN,MULTICARE COVINGTON MEDICAL CENTER, COVINGTON,MULTICARE DEACONESS HOSPITAL, SPOKANE,MULTICARE VALLEY HOSPITAL, SPOKANE VALLEY,MULTICARE CAPITAL MEDICAL CENTER, THURSTON COUNTYNAVOS, SEATTLE.THE URGENT CARE LINE IS MAINLY REPRESENTED BY INDIGO URGENT CARE CLINICS AND ROCKWOOD CLINIC. THE INDIGO CLINICS PROVIDE QUICK CARE FOR LOWER-ACUITY CONDITIONS SEVEN DAYS A WEEK AND ARE SERVING NEIGHBORHOODS THROUGHOUT PIERCE, KING, THURSTON, SNOHOMISH AND SPOKANE COUNTIES. IN 2022 MULTICARE AND KOOTENAI HEALTH JOINED THEIR EFFORTS TO OPEN A CLINIC IN IDAHO, INDIGO IDAHO, THAT WILL SIMILARLY SERVE NORTHERN IDAHO.MULTICARE ROCKWOOD CLINIC IS THE LARGEST MULTI-SPECIALTY CLINIC SYSTEM IN THE INLAND NORTHWEST REGION WITH MULTIPLE LOCATIONS OFFERING PRIMARY CARE, URGENT CARE AND SPECIALTY CARE. THE MULTICARE ROCKWOOD CLINIC HAS LOCATIONS STRETCHING FROM MOSES LAKE, WA, TO C'OEUR D'ALENE, IDAHO, OFFERING COMPREHENSIVE PRIMARY AND SPECIALTY CARE.IN ADDITION TO THE LINES OF CARE DESCRIBED ABOVE, MULTICARE INCLUDES HIGHLY SPECIALIZED AFFILIATED ENTITIES, SUCH AS CHVI PULSE HEART INSTITUTE, SPECIALIZED IN THE TREATMENT AND RESEARCH OF THE HEART, AND MULTICARE REHABILITATION SPECIALISTS P.C., AN ENTITY FOCUSED FOR DELIVERING ACCESSIBLE AND AFFORDABLE PHYSICAL AND REHABILITATION THERAPY SERVICES.THROUGH ITS AFFILIATIONS WITH NAVOS (2017) AND GREATER LAKES MENTAL HEALTH (2018) MULTICARE IS THE LARGEST BEHAVIORAL HEALTH PROVIDER IN WASHINGTON STATE. IN 2019 MULTICARE HEALTH SYSTEM IN PARTNERSHIP WITH VIRGINIA MASON FRANCISCAN HEALTH OPENED WELLFOUND BEHAVIORAL HEALTH HOSPITAL, A NOT-FOR-PROFIT MENTAL HEALTH HOSPITAL IN TACOMA, WASHINGTON, FURTHER ADDRESSING THE NEED FOR MENTAL HEALTH AND WELLBEING IN THE COMMUNITY. SINCE THEN, WELLFOUND HAS CREATED AN IMPLEMENTATION STRATEGY TO ADDRESS ITS COMMUNITY IN THE AREAS OF ACCESS TO CARE, SUICIDE, DRUG AND ALCOHOL USE, AND DEPRESSION. MULTICARE'S AFFILIATION WITH THESE ORGANIZATIONS ALLOWS TO BETTER PROVIDE ESSENTIAL BEHAVIORAL HEALTH SERVICES AND CONNECT OUR PATIENTS TO ESSENTIAL COMMUNITY RESOURCES. PART VI, LINE 7, REPORTS FILED WITH STATES WA 1 MARY BRIDGE CHILDREN'S FOUNDATION PO BOX 5299 TACOMA WA 98415 943030039 501(C)(3) 3637167 0 ASSISTANCE FOR OPERATING EXPENSES. MULTICARE FOUNDATIONS PO BOX 5300 TACOMA WA 98415 911514257 501(C)(3) 6319648 0 ASSISTANCE FOR OPERATING EXPENSES PACIFIC NORTHWEST UNIVERSITY 111 UNIVERSITY PARKWAY YAKIMA WA 98901 061744054 501(C)(3) 3185509 0 SUPPORT THE GROWTH AND CAMPUS EXPANSION. MEDICAL TEAMS INTERNATIONAL - MOBILE DENTAL CLINICS 2225 4TH AVE 200 SEATTLE WA 97208 930878944 501(C)(3) 50000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, GENERAL SUPPORT FOR OPERATIONS LINDQUIST DENTAL CLINIC FOR CHILDREN 130 131ST ST S TACOMA WA 98444 910615378 501(C)(3) 20000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, GENERAL SUPPORT FOR OPERATIONS SALVATION ARMY OF SPOKANE 222 E INDIANA AVE SPOKANE WA 99207 941156347 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND TO THE UNCOMPENSATED CARE FUND. COMMUNITIES IN SCHOOLS OF SPOKANE COUNTY 104S FREYA ST STE 109 SPOKANE WA 99202 261581358 501(C)(3) 20000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS COMMUNITY HEALTH ASSOCIATION OF SPOKANE (CHAS HEALTH) 611 N IRON BRIDGE WY SPOKANE WA 99202 911641797 501(C)(3) 21500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS LUTHERAN COMMUNITY SERVICES NW 210 W SPRAGUE AVE SPOKANE WA 99201 930386860 501(C)(3) 22500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS VINE MAPLE PLACE 21730 DORRE DON WAY SE MAPLE VALLEY WA 98038 912082308 501(C)(3) 12500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS TACOMA PIERCE COUNTY HABITAT FOR HUMANITY 4824 S TACOMA WAY TACOMA WA 98409 581735531 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS SOUTH PUGET SOUND HABITAT FOR HUMANITY 1216 2ND AVE TUMWATER WA 98512 911427020 501(C)(3) 7000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS NOURISH PIERCE COUNTY 1702 S 272ND ST STE E TACOMA WA 98408 911198391 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT FOR OPERATIONS EMERGENCY FOOD NETWORK 3318 92ND ST S LAKEWOOD WA 98499 943131776 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT THE GENERAL OPERATIONS PARTNERS WITH FAMILIES & CHILDREN 106 W MISSION AVE SPOKANE WA 99201 680576560 501(C)(3) 22500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND, SUPPORT FOR OPERATIONS FAIL SAFE FOR LIFE P O BOX 28955 SPOKANE WA 99208 813525568 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT BIG TABLE P O BOX 372 SPOKANE WA 99210 208931223 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: SUPPORT FOR OPERATIONS OASIS YOUTH CENTER 2215 PACIFIC AVE TACOMA WA 98402 911385245 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT LUTHERAN COMMUNITY SERVICES NW NORTHWEST SPS DISTRICT TACOMA WA 98409 930386860 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: SUPPORT FOR OPERATIONS. AMERICAN RED CROSS - SOUTH PUGET SOUND & OLYMPICS-BLOOD GIVES LIFES 1235 S TACOMA WAY TACOMA WA 98408 530196605 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT BOYS & GIRLS CLUBS OF SOUTH PUGET SOUND 3875 S 66TH ST STE 101 TACOMA WA 98409 910759832 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT EATONVILLE AREA COUNCIL DBA EATONVILLE FAMILY AGENCY 305 CENTER ST W EATONVILLE WA 98328 911059530 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT TACOMA RESCUE MISSION 425 S TACOMA WAY TACOMA WA 98402 910565014 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND:GENERAL SUPPORT AMARA 3501 104TH AVE E TACOMA WA 98446 910577487 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT COMMUNITIES IN SCHOOLS OF PUYALLUP 302 SECOND ST SE PUYALLUP WA 98372 260028759 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT FIVE FIVE FUNDAMENTALS 1501 PACIFIC AVE210 TACOMA WA 98402 800209462 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT HOPESPARKS FAMILY SERVICES 6424 N 9TH ST TACOMA WA 98406 910598103 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT INTERFAITH WORKS 110 11TH AVE SE OLYMPIA WA 98501 910947698 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT PIERCE COUNTY AIDS FOUNDATION 3009 S 40TH ST TACOMA WA 98409 921385245 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT RAINBOW CENTER 2215 PACIFIC AVE TACOMA WA 98402 911859897 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT ST VINCENT DE PAUL TACOMA-PIERCE COUNTY 4009 S 56TH TACOMA WA 98409 910580490 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT TACOMA URBAN LEAGUE 2550 S YAKIMA AVE STE A TACOMA WA 98405 910826302 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT THE TEARS FOUNDATION 11102 SUNRISE BLVD E 112 PUYALLUP WA 98374 450500497 501(C)(3) 7500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT VANESSA BEHAN 2230 E SPRAGUE SPOKANE WA 99202 911196575 501(C)(3) 22500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT WOMEN'S CENTER DBA SAFE PASSAGE 611 N IRON BRIDGE WY SPOKANE WA 99202 911641797 501(C)(3) 22500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT EASTERN WASHINGTON UNIVERSITY - DENTAL HYGIENE CLINIC 102 HARGREAVES HALL CHENEY WA 99004 911019819 501(C)(3) 21000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT HISPANIC BUSINESS PROFESSIONAL ASSOCIATION OF SPOKANE 308 W 1ST AVE SPOKANE WA 99223 743200153 501(C)(3) 15000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT NORTHEAST YOUTH CENTER 3004 E QUEEN AVE SPOKANE WA 99217 710886315 501(C)(3) 15000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT SECOND HARVEST INLAND NORTHWEST 1234 E FRONT AVE SPOKANE WA 99202 237173826 501(C)(3) 10000 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT YWCA SPOKANE 930 N MONROE SPOKANE WA 99201 910565025 501(C)(3) 22500 0 CONTRIBUTION FROM THE MULTICARE COMMUNITY PARTNERSHIP FUND: GENERAL SUPPORT 40 0 PART I, LINE 2: THE MULTICARE COMMUNITY PARTNERSHIP FUND PROVIDES FUNDING TO NOT-FOR-PROFIT COMMUNITY ORGANIZATIONS IN PIERCE, KING, THURSTON, KITSAP, LEWIS, WHITMAN AND SPOKANE COUNTIES THAT ADVANCE INITIATIVES, PROGRAMS, AND PROJECTS THAT IMPROVE THE HEALTH OF THE COMMUNITY, INCLUDING THROUGH PARTNERSHIP WITH ORGANIZATIONS THAT AFFECT THE SOCIAL DETERMINANTS OF HEALTH. AFTER THE APPLICANTS ARE VALIDATED AS 501(C)(3) ORGANIZATIONS AND PROVIDED THE FUNDS, MULTICARE HEALTH SYSTEM THEN SEES THE BENEFITS OF THOSE ORGANIZATIONS IN THE COMMUNITY. RESEARCH IS CONDUCTED TO ENSURE THE INTEGRITY AND ETHICS OF EACH OF THE ORGANIZATIONS. X 1 0 X X X X 1 1 0 0 0 0 0 0 0 WILLIAM ROBERTSON CEO 1910400 0 542506 0 298922 0 831790 0 24939 0 3608557 0 0 0 FLORENCE CHANG PRESIDENT 1434058 0 355636 0 239332 0 612073 0 21243 0 2662342 0 0 0 LEE SANDQUIST MD PHYSICIAN 1995058 0 34325 0 1582 0 10675 0 21898 0 2063538 0 0 0 NEHAL MASOOD MD PHYSICIAN 1592108 0 173104 0 14011 0 18300 0 25130 0 1822653 0 0 0 ARCHIE ADAMS MD PHYSICIAN 1472045 0 80425 0 12229 0 18300 0 26984 0 1609983 0 0 0 ESTHER M PARK-HWANG MD PHYSICIAN 1317639 0 88473 0 30811 0 18300 0 27125 0 1482348 0 0 0 DAVID J CARLSON SRVP,EXEC SOUTH SOUND,PART YEAR 654969 0 180768 0 617358 0 0 0 24027 0 1477122 0 0 0 BENJAMIN Y CHEN MD PHYSICIAN 1274751 0 139723 0 12829 0 18300 0 29055 0 1474658 0 0 0 JAMES MCMANUS FORMER CFO 140876 0 177960 0 1023307 0 0 0 1587 0 1343730 0 0 0 JUNE ALTARAS SRVP,CHIEF NURSING ENTREPRISE 806067 0 175770 0 130861 0 12200 0 21243 0 1146141 0 0 0 DAVID R O'BRIEN SRVP,CHIEF PHYS.OFFICER/EXEC.SOUTH S 813349 0 152251 0 129448 0 12200 0 18930 0 1126178 0 0 0 JEFFREY POLTAWSKY PRES. MARY BRIDGE&PEDIATRIC NETWORK 457030 0 138088 0 71925 0 12200 0 25051 0 704294 0 0 0 ALEXANDER M JACKSON SVP EXEC.INLAND NW 538329 0 65073 0 6137 0 12200 0 12652 0 634391 0 0 0 JAMES LEE CFO 523568 0 70000 0 2816 0 0 0 11289 0 607673 0 0 0 TIMOTHY W LYNCH SRVP,CLINICAL SERVICES(LAB,PHARMACY, 501050 0 60945 0 5385 0 12200 0 27963 0 607543 0 0 0 CHRISTI MCCARREN SRVP,RETAIL HEALTHCARE,PART YEAR 351549 0 114384 0 44468 0 18300 0 12024 0 540725 0 0 0 PART I, LINE 1A LINE 1A - THE EXECUTIVE BENEFIT ALLOWANCE IS A DISCRETIONARY SPENDING ACCOUNT AND THERE ARE NO RESTRICTIONS AS TO HOW THE FUNDS ARE TO BE SPENT. FIVE KEY EMPLOYEES RECEIVED EXECUTIVE BENEFIT ALLOWANCE IN 2022. THEY CAN CHOOSE TO AUGMENT THEIR BENEFITS OR RECEIVE IT AS COMPENSATION PART OF TAXABLE WAGES. THE PAYMENTS WERE TAXED AND INCLUDED IN COLUMN B,(III). PART I, LINES 4A-B LINE 4A - IN 2022 THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS: DAVID CARLSON - $217,962 AND JAMES MCMANUS- $684,460. LINE 4B - THE FOLLOWING REPORTED PEOPLE PARTICIPATED IN A 457(F) DEFERRED COMPENSATION PLAN AND RECEIVED A PAYOUT IN 2022: DAVID CARLSON - $271,245 AND JAMES MCMANUS- $292,896. IRC SECTION 457(F) PLANS ALLOW PARTICIPANTS TO CHOOSE FROM A NUMBER OF DIFFERENT TYPES OF BENEFITS WITH A DEFAULT SELECTION INTO A 457(F) PLAN. THE PLAN COVERS EMPLOYEES WHO ARE PRIMARILY A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THIS TYPE OF ARRANGEMENT CONTAINS A RISK OF FORFEITURE AND SOME OF THE ACCOUNTS USE A NON-COMPETE CLAUSE. THE EXECUTIVE GROUP ACCOUNTS CONTAIN A ROLLING 5-YEAR CLIFF 50% VESTING SCHEDULE AND ONCE THAT IS BEING MET THE PARTICIPANT RECEIVES 50% OF THE ACCOUNT, WITH A 100% VESTING UPON AGE 62 OR 5 YEARS OF PRIOR EMPLOYMENT. FOR THE HIGHLY COMPENSATED GROUP (PLAN'S LEGACY PHYSICIAN PARTICIPANT GROUP) DISTRIBUTION OF BALANCES PAID REPRESENTED VESTED AMOUNT DURING THE YEAR. THE PAYMENTS WERE TAXED AND INCLUDED IN COLUMN B, (III). PART II, COLUMN III: DEFERRED COMPENSATION AMOUNTS, SERP VESTED TAXABLE DISTRIBUTIONS, WERE PAID OUT TO THE FOLLOWING INDIVIDUALS: FLORENCE CHANG - $228,713 AND WILLIAM ROBERTSON - $288,038. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN HAS A VESTING SCHEDULE; THE VESTED BENEFIT WAS PAID OUT AS ORDINARY INCOME (REPORTED ON W-2) AS OF THE PARTICIPANT'S VESTING DATE MILESTONE. THE PAYMENT WAS TAXED AND INCLUDED IN COLUMN B,(III). SCHEDULE J, COLUMN C, SUPPLEMENTAL INFORMATION: WILLIAM G. ROBERTSON, CEO, AND FLORENCE CHANG, PRESIDENT, EARNED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) INCOME IN THE AMOUNTS OF $593,773 AND $813,490, RESPECTIVELY, WHICH ARE REFLECTED IN COLUMN C. THE SERP PLAN HAS DEFERRALS INTO THE 457(F) CAA DEFERRED COMPENSATION PLAN. FORM 990, PART VII AND SCHEDULE J, PART III- SUPPLEMENTAL THE REPORTABLE COMPENSATION FOR THE OFFICERS OF THE CORPORATION AND KEY EMPLOYEES IS BASED ON THE TOTAL AMOUNT PAID DURING THE YEAR FOR MANAGEMENT AND LEADERSHIP OF MULTICARE HEALTH SYSTEM ENTITIES (91-1514257, 94-3030039, 47-5457904, 82-2949880). THE AMOUNTS UNDER OTHER COMPENSATION INCLUDE DEFERRED COMPENSATION, AND THE VALUE OF MEDICAL, DENTAL, LIFE, DISABILITY INSURANCE, AND PENSION BENEFITS. COMPENSATION ON THIS TAX RETURN INCLUDES AMOUNTS THAT ARE NOT VESTED, ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE AND MAY NOT BE PAID OUT IN THE FUTURE. THE PROCESS FOR DETERMINING EXECUTIVE COMPENSATION AT MULTICARE HEALTH SYSTEM (I) COMPLIES WITH IRS GUIDELINES FOR TAX-EXEMPT ORGANIZATIONS; (II) IS DETERMINED BY A SEPARATE COMMITTEE OF THE BOARD OF DIRECTORS WHOSE MEMBERS ARE ALL INDEPENDENT, DO NOT HAVE A CONFLICT OF INTEREST, AND ARE NON-PAID; AND (III) IS ANNUALLY EVALUATED IN THE CONTEXT OF COMPENSATION DATA GATHERED BY INDEPENDENT EXTERNAL CONSULTANTS FROM A PEER GROUP COMPRISED OF SIMILAR HIGH PERFORMING HEALTHCARE INSTITUTIONS, PRIMARILY INTEGRATED HEALTHCARE ORGANIZATIONS. COMPENSATION PAID IS DETERMINED TO BE REASONABLE AND NECESSARY BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE INDEPENDENT EXTERNAL CONSULTANT. IN ADDITION, A SIGNIFICANT PORTION OF COMPENSATION IS AT RISK AND BASED ON ACHIEVEMENT OF GOALS SET BY THE BOARD OF DIRECTORS AT THE START OF EACH YEAR IN AREAS SUCH AS PATIENT SAFETY, QUALITY, WORKFORCE DEVELOPMENT, FINANCE AND OTHER MISSION-RELATED AREAS. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECRUIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE TO DRIVE SUPERIOR ORGANIZATIONAL PERFORMANCE IN ORDER TO ACHIEVE TOP TIER INTEGRATED CARE DELIVERY SYSTEM STATUS. THE COMPENSATION COMMITTEE ROUTINELY REVIEWS BENEFITS AND RETIREMENT PROGRAMS TO ENSURE THE PLANS ARE MARKET-BASED AND OTHERWISE CONSISTENT WITH IRS GUIDELINES. THE OFFICERS OF MULTICARE HEALTH SYSTEM, 91-1352172, ALSO FULFILL OFFICER AND EXECUTIVE FUNCTIONS FOR ITS RELATED ENTITIES. COMPENSATION DISCLOSED IS REPORTED TO THE RELATED ENTITIES TAX RETURNS IN ACCORDANCE WITH IRS REGULATIONS, BUT IS NOT CHARGED TO THE SUBSIDIARY OR AFFILIATE. AN OFFICER LISTED DEVOTES AN AVERAGE OF 60 HOURS PER WEEK TO PERFORM HIS OR HER RESPONSIBILITIES. A WASHINGTON HEALTH CARE FACILITIES SERIES 2015 AB 911108929 93978HMN2 2015-04-09 420539219 REFUND SERIES 2004 & 2008 DEBT, CONSTRUCTION AT AUBURN & COVINGTON 0 0 0 B WASHINGTON HEALTH CARE FACILITIES SERIES 2017 B 911108929 93978HTS4 2017-11-14 299865868 REFUND THE SERIES 2007 DEBT 0 0 0 C WASHINGTON HEALTH CARE FACILITIES SERIES 2017 CDE 911108929 93978HTS3 2017-11-14 191010000 ROCKWOOD ACQUISITION 0 0 0 D WASHINGTON HEALTH CARE FACILITIES SERIES 2022 A 911108929 93978HYM1 2022-08-16 49985000 CONSTRUCTION GOOD SAMARITAN TOWER 0 0 0 A 28265000 420539219 3145115 192374556 225019548 2017 1 0 1 1 B 19420000 299865868 299865868 2017 1 0 1 1 C 80000000 191010000 191010000 2017 1 0 1 1 D 49985000 49985000 2022 1 0 1 1 A 0 1 1 1 1 1 0.00300 0.00000 0.00300 0 0 1 B 0 1 1 1 1 1 0.00380 0.00000 0.00380 0 0 1 C 0 1 1 1 1 1 0.00470 0.00000 0.00470 0 0 1 D 0 1 1 1 1 1 0.00160 0.00000 0.00160 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART I, COLUMN C THE FOLLOWING CUSIPS WERE ISSUED FOR THE FOLLOWING BOND SERIES: $87,710,000 ISSUER BOND DESCRIPTION MULTICARE HEALTH SYSTEM SERIES 2015A MATURITY/CUSIP 8/15/2019/ 93978HMP7 8/15/2020/ 93978HMQ5 8/15/2021/ 93978HMR3 8/15/2022/ 93978HMS1 8/15/2023/ 93978HMT9 8/15/2024/ 93978HMU6 8/15/2025/ 93978HMV4 8/15/2026/ 93978HMW2 8/15/2027/ 93978HMX0 8/15/2028/ 93978HMY8 8/15/2029/ 93978HMZ5 8/15/2030/ 93978HNA9 8/15/2031/ 93978HNB7 8/15/2032/ 93978HNC5 8/15/2033/ 93978HND3 8/15/2034/ 93978HNE1 8/15/2035/ 93978HNF8 8/15/2040/ 93978HNG6 8/15/2045/ 93978HNH4 $285,680,000 ISSUER REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2015B MATURITY/CUSIP 8/15/2019/ 93978HNN1 8/15/2020/ 93978HNP6 8/15/2021/ 93978HNQ4 8/15/2022/ 93978HNR2 8/15/2023/ 93978HNS0 8/15/2024/ 93978HNT8 8/15/2025/ 93978HNU5 8/15/2026/ 93978HNV3 8/15/2027/ 93978HNW1 8/15/2028/ 93978HNX9 8/15/2029/ 93978HNY7 8/15/2030/ 93978HNZ4 8/15/2031/ 93978HPA7 8/15/2032/ 93978HPB5 8/15/2033/ 93978HPC3 8/15/2034/ 93978HPD1 8/15/2035/ 93978HPE9 8/15/2039/ 93978HPF6 8/15/2043/ 93978HPG4 $271,560,000 WA HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2017B (REFUNDING) MATURITY/CUSIP 8/15/2019/ 93978HSW6 8/15/2020/ 93978HSX4 8/15/2021/ 93978HSY2 8/15/2022/ 93978HSZ9 8/15/2023/ 93978HTA3 8/15/2024/ 93978HTB1 8/15/2025/ 93978HTC9 8/15/2026/ 93978HTD7 8/15/2027/ 93978HTE5 8/15/2028/ 93978HTF2 8/15/2029/ 93978HTG0 8/15/2030/ 93978HTH8 8/15/2031/ 93978HTJ4 8/15/2032/ 93978HTK1 8/15/2033/ 93978HTL9 8/15/2034/ 93978HTM7 8/15/2035/ 93978HTN5 8/15/2036/ 93978HTP0 8/15/2037/ 93978HTQ8 8/15/2038/ 93978HTR6 8/15/2041/ 93978HTS4 SCHEDULE K, PART VI, ARBITRAGE COLUMN A (SERIES 2015 A, B) FOR THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS SERIES 2015 A,B MULTICARE HEALTH SYSTEM ENGAGED RITZ & ASSOCIATES PROFESSIONAL ASSOCIATION TO PERFORM A FIVE-YEAR ARBITRAGE CALCULATION ON 09/29/2019 AND THE RESULT WAS THERE IS NO REBATE DUE TO THE IRS. COLUMN B (SERIES 2017 B) FOR THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS SERIES 2017 B,C,D MULTICARE HEALTH SYSTEM ENGAGED RITZ & ASSOCIATES PROFESSIONAL ASSOCIATION TO PERFORM A FIVE-YEAR ARBITRAGE CALCULATION ON 08/15/2022 AND THE RESULT WAS THERE IS NO REBATE DUE TO THE IRS. COLUMN C (SERIES 2017 C, D, E) FOR THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS SERIES 2017 B,C,D MULTICARE HEALTH SYSTEM ENGAGED RITZ & ASSOCIATES PROFESSIONAL ASSOCIATION TO PERFORM A FIVE-YEAR ARBITRAGE CALCULATION ON 08/16/2022 AND THE RESULT WAS THERE IS NO REBATE DUE TO THE IRS. A WASHINGTON HEALTH CARE FACILITIES SERIES 2022 B 911108929 93978HYM1 2022-08-16 108145000 AUBURN ACQUISITION, TACOMA GENERAL CAMPUS REFRESH COVINGTON ED 0 0 0 B WASHINGTON HEALTH CARE FACILITIES SERIES 2022 C 911108929 93978HYN9 2022-12-15 80000000 AUBURN ACQUISITION, TACOMA GENERAL CAMPUS REFRESH COVINGTON ED 0 0 0 A 108145000 108145000 2022 1 0 1 1 B 80000000 80000000 2022 1 0 1 1 A 0 1 1 1 1 1 0.00080 0.00000 0.00080 0 0 1 B 0 1 1 1 1 1 0.00080 0.00000 0.00080 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 2 JANINE TERRANO AND JOHN FOLSOM HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 THE FIRST AMENDMENT DATED 06/2022 TO THE RESTATED BYLAWS CHANGES ONE OF THE OFFICER POSITIONS AS FOLLOWS: ALL REFRENCES CONTAINED IN THE BYLAWS TO "PRESIDENT AND CHIEF EXECUTIVE OFFICER" ARE AMENDED TO READ "CHIEF EXECUTIVE OFFICER", ALONG WITH THE RESERVATION OF ALL AUTHORITIES, DUTIES AND RESPONSIBILITIES TO THE CHIEF EXECUTIVE OFFICER FORMERLY ATTRIBUTED TO THE "PRESIDENT AND CHIEF EXECUTIVE OFFICER" PRIOR TO THIS AMENDMENT. FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 THE MULTICARE HEALTH SYSTEM (MHS) FORM 990 IS PREPARED BY INTERNAL STAFF AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM. INITIAL REVIEWS ARE PERFORMED BY LEVELS OF MANAGEMENT IN VARIOUS DEPARTMENTS THROUGHOUT THE ORGANIZATION, INCLUDING THE CHIEF EXECUTIVE OFFICER, AND THE CHIEF FINANCIAL OFFICER. A REVIEW IS THEN PERFORMED BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD, WITH A PRESENTATION BY THE OUTSIDE ACCOUNTING FIRM. LASTLY, A COPY OF THE FINAL FORMS 990 FOR MHS, MULTICARE FOUNDATIONS AND MARY BRIDGE CHILDREN'S FOUNDATION, INCLUDING ALL REQUIRED SCHEDULES, ARE POSTED TO DILIGENT BOARD BOOKS, A SECURE BOARD PORTAL WHERE THE MHS'S BOARD OF DIRECTORS HAVE ACCESS TO REVIEW/GAIN KNOWLEDGE/ASK QUESTIONS, PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS USED TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST THE BOARD OF DIRECTORS HAS ACCOUNTABILITY FOR OVERSIGHT OF THE PROCESS FOR DISCLOSURE, EVALUATION, AND MANAGEMENT OF CONFLICTS OF INTEREST INVOLVING ANY DIRECTOR ON THE BOARD, EXECUTIVE LEADERSHIP, OR KEY EMPLOYEE. IN ACCORDANCE WITH THE CONFLICTS OF INTEREST POLICY, THESE INDIVIDUALS ARE REQUIRED TO COMPLETE THE CONFLICTS OF INTEREST QUESTIONNAIRE AT LEAST ANNUALLY, AND HAVE AN ONGOING OBLIGATION TO UPDATE THE DISCLOSURE IN THE EVENT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. THE CONFLICTS OF INTEREST QUESTIONNAIRE INCLUDES A STATEMENT THAT THE PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT FURTHER ITS TAX EXEMPT PURPOSES. WRITTEN DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER, AND IN CERTAIN CIRCUMSTANCES, THERE IS FURTHER REVIEW BY THE GENERAL COUNSEL AND THE MEMBER. NO PERSON WITH A CONFLICT OF INTEREST PARTICIPATES IN AN ACTIVITY RELATED TO THE CONFLICT OF INTEREST UNLESS DISCLOSED, RESOLVED, AND PERMITTED IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. CONFLICTS OF INTEREST ARE DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 15 A AND B, PROCESS USED TO DETERMINE COMPENSATION OF THE CEO, CFO, TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES: THE BOARD, THROUGH ITS COMPENSATION COMMITTEE, CONSISTING OF INDEPENDENT, NON-PAID, MHS BOARD MEMBERS, ARE ACCOUNTABLE FOR ENSURING AND APPROVING A REASONABLE TOTAL COMPENSATION PACKAGE, CONSISTENT WITH ITS COMPENSATION PHILOSOPHY, FOR THE CEO, CFO, TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES FOR THEIR MANAGEMENT AND LEADERSHIP OF MULTICARE HEALTH SYSTEM ENTITIES (91-1514257, 94-3030039, 91-1111928, 82-2949880,47-5457904). UPON THE IDENTIFICATION OF THE COMPENSATION FOR THE YEAR, THE INDEPENDENT CONSULTANT SULLIVAN COTTER, REVIEWS THE COMPENSATION AS PROPOSED BY THE BOARD OF DIRECTORS, AND CONDUCTS AN INDEPENDENT REVIEW. AT THE CONCLUSION OF THIS REVIEW, SULLIVAN COTTER ISSUES A REASONABLENESS OPINION TO MULTICARE HEALTH SYSTEM. THIS IS DONE ANNUALLY AND WAS DONE FOR THIS CURRENT YEAR. THE INDEPENDENT CONSULTANTS ASSESSED THAT THE COMPENSATION APPROVED BY THE BOARD FOR 2022 WAS OBJECTIVELY REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO INCLUDED AS PART OF THE FORM 990. FORM 990, PART XI, LINE 9: CHANGES IN ACCRUED PENSION ASSET -15,507,775. TRANSFER OF ASSETS- RELATED ENTITIES 15,241,440. 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