2024-11-15T07:33:38-06:00 2023-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-01-01 910171250 Central Washington Health Services Association CENT 5096621515 1201 S Miller St Wenatchee WA 98801 Tom Legel Chief Financial Officer 5096621515 2024-11-14 1 1 Kim Hunwardsen CPA P00484560 6122536500 2024-11-14 2023 2024-10-15 13:58:12Z Confluence Health Tom Legel 1201 S Miller St Wenatchee WA 98801 759429343 0 X www.confluencehealth.org X 1978 WA Dedicated to improving our patients' health by providing safe, high-quality care. 15 15 4092 80 0 0 11936909 2126896 561251903 623443285 18324210 3994672 1670404 0 593183426 629564853 266029 809868 0 0 170017481 287940139 0 0 0 398967916 333212143 569251426 621962150 23932000 7602703 546160334 721175126 129595570 268734419 416564764 452440707 X Local care by and for our community. 1 0 492194653 809868 623443285 Confluence Health is an integrated healthcare delivery system that serves as the major medical provider for four counties in North Central Washington. With 305 physicians, 158 advanced practice providers, 30 medical specialties, one hospital in two locations, and primary care services, Confluence Health provides high-quality, compassionate, cost-effective care close to home. Staying on the leading edge of healthcare innovation is important, so we invest in technology and resources to provide better care for our patients and to allow our providers to operate at the highest level.Continued on Schedule OOn October 7, 2023, Confluence Health celebrated the grand opening of its new $15 million Moses Lake Radiation Oncology Center. With a size of nearly 7,000 square feet situated on 1.5 acres, the new facility provides a complete offering for cancer care in Grant County and surrounding areas. Patients undergoing radiation therapy often need treatment five days a week for several consecutive weeks. Previously, patients would have to travel for over an hour to Wenatchee or Spokane to receive care. Through this new radiation oncology center, Confluence Health can provide full-spectrum cancer care in Moses Lake and neighboring communities. This center was helped made possible through the generous support of donors and the Confluence Health Foundation, which has provided over $3 Million over the past 4 years. In 2023, Confluence Health was recognized for excellence in Cardiovascular care. Confluence Health was awarded the 2023 Award of Excellence in Cardiovascular Surgery from the Foundation for Health Care Quality with the Cardiac Care Outcomes Assessment Program. The institution has 32 participating sites across the state and supports clinicians and hospitals in delivering patient care. To earn this award, a facility must meet or surpass the state's average markers for at least six out of the total eight key quality indicators in the assessment year. The second award is the Mission: Lifeline NSTEMI Gold achievement award from the American Heart Association. This award recognizes the commitment to offering rapid and high-quality care to patients that experience non-ST elevation myocardial infarction (NSTEMI), which is a specific kind of heart attack that more than 546,000 people experience every year.In 2023, Confluence Health was awarded two awards from LifeCenter Northwest. LifeCenter Northwest works collaboratively with more than 200 hospitals in the region to save lives through organ and tissue donation. Each year, hospitals that meet certain robust criteria are honored for their efforts in the organization's annual report. For the 2023 annual report released this month, Confluence Health Hospital Central Campus, previously called Central Washington Hospital was honored with two such awards. The first award, the Organ Donation Process Excellence Award, previously called the Donation Referral Achievement Award Organ, is granted to hospitals who have a process error rate of 5% or less. Realizing and maintaining a low process error rate is incredibly challenging and requires a strong commitment across hospital services and staff. Confluence Health Hospital Central Campus was one of only 29 hospitals to earn this honor in this organ donation service area. Confluence Health has previously been honored with this award five times before (2017, 2019, 2020, 2021, 2022). The second award, the Honoring Donor Decisions Award, is earned by hospitals honoring 100% of registered donation decisions in collaboration with LifeCenter Northwest. Confluence Health Hospital Central Campus was one of only 46 hospitals in the organ donation service area to receive this award this year. 492194653 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 419 0 1 4092 1 0 0 0 0 0 0 0 0 0 0 1 0 X 15 15 1 0 1 0 1 1 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X Tom Legel 5094333809 1201 South Miller Street Wenatchee WA 98801 Doug Shae Chair 3.00 4.00 X X 15000 0 0 Cori Bautista Vice Chair 3.00 4.00 X X 13500 0 0 Gus Heinicke Treasurer 2.00 4.00 X X 10000 0 0 Abraham Sorom MD Secretary 2.00 4.00 X X 0 0 0 Dave Balcom Board Member 2.00 2.00 X 10000 0 0 Mable Bodell Board Member 2.00 2.00 X 0 0 0 Garn Christensen Board Member 2.00 2.00 X 10000 0 0 Jenny Cravens Board Member 2.00 2.00 X 11500 0 0 Vanessa Gutierrez Board Member 2.00 2.00 X 10000 0 0 Greg Hamilton Board Member 2.00 2.00 X 10000 0 0 Jennifer Jorgensen MD Board Member 1.00 2.00 X 0 0 0 James Murray MD Board Member 1.00 2.00 X 0 0 0 Catherine Ridgeway MD Board Member 1.00 2.00 X 0 0 0 Vicky Sharleau Board Member 2.00 2.00 X 10000 0 0 Michael Tuggy Board Member 1.00 2.00 X 0 0 0 Mitchell A Garrision Board Member (January) 2.00 2.00 X 0 0 0 Tom Tuszynski Board Member (January) 2.00 2.00 X 0 0 0 Andrew Jones MD Chief Executive Officer 40.00 15.00 X 778769 0 51928 Tom Legel Chief Financial Officer 40.00 15.00 X 601951 0 45975 Robert Pageler Chief Information Officer 40.00 15.00 X 424371 0 30796 Kelly Allen Chief Nursing Officer 50.00 0.00 X 317120 0 30092 Katina Maier Chief People & Strategy Officer 40.00 15.00 X 560137 0 29499 Glenn Adams Chief Operations Officer (thru June) 40.00 15.00 X 981713 0 37294 Jason Lake MD Chief Medical Officer (thru Sept) 30.00 15.00 X 513732 0 50471 Kris Deyerle VP General Counsel 50.00 0.00 X 379926 0 41723 Eric Caldwell VP, Finance 50.00 0.00 X 264424 0 46227 Thomas Christensen VP of Human Resources 50.00 0.00 X 276191 0 12129 Jay Johnson VP Managed Care & Gov 50.00 0.00 X 269327 0 39258 Mauvia Sorensen ARNP - Behavior Health 50.00 0.00 X 271431 0 39998 Jonathan Stoever MD Physician 50.00 0.00 X 445838 0 49178 Joellen Colson Former Key VP Ancillary Services 50.00 0.00 X 109112 0 24605 Sarah Battis Johnson Former Key) VP Quality Care Transformation 50.00 0.00 X 243617 0 37674 Staci Jones Former Key VP Sr Specialty Care 50.00 0.00 X 232768 0 26744 Tracey Kasnic Former Key CNO/Hospital Administrator (thru July) 50.00 0.00 X 440245 0 23451 7210672 0 617042 457 1 1 1 Wenatchee Valley Medical Group 820 N Chelan Ave Wenatchee WA 98801 Physician Services 150962785 Wenatchee Emergency Physicians PC INC PO Box 4600 Wenatchee WA 98807 Physician Services 14157307 University of Washington PO Box 24366 Seattle WA 98124 Laboratory Services 2182299 Mayo Collaborative Service PO Box 9146 Minneapolis MN 55480 Collaborative Services 2078582 Quest Diagnostics PO Box 912400 Pasadena CA 91110 Laboratory Services 1734007 38 1198920 927976 551000 2126896 Net Patient Service Revenue 621110 583055403 583055403 Managed Care Revenue 541610 24758764 24758764 Pharmacy Revenue 456110 2442079 2442079 Cafeteria Revenue 722514 1503645 1503645 11683394 11683394 623443285 6632673 6632673 127199389 27100 129864490 0 -2665101 27100 -2638001 -2638001 629564853 623443285 0 3994672 X 743081 743081 66787 66787 4431843 1387675 3044168 1147943 872437 275506 211787344 153750317 58037027 6786402 4697500 2088902 52581129 36238192 16342937 11205478 7712896 3492582 1159800 1159800 723285 723285 69102 69102 706074 706074 147700039 133266104 14433935 8647971 6608266 2039705 7095613 1823478 5272135 447456 447456 4940750 4940750 16534463 8058398 8476065 8644807 2704912 5939895 Medical Supplies 128267895 128267895 Taxes & Licenses 7904256 5928192 1976064 370632 68523 302109 621962150 492194653 129767497 0 10099 29525 8622213 38704423 83406684 132767302 22150055 0 6968474 8259127 2836483 11055049 496959907 302630590 143807961 194329317 241394531 267274320 16237423 28576471 20726411 40179592 546160334 721175126 24794736 73885557 99490291 135744611 5310543 59104251 129595570 268734419 X 400327341 434295055 16237423 18145652 416564764 452440707 546160334 721175126 X 7602703 31656123 -3382883 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 69102 69102 0 Part II-B, Line 1: WA State Hospital Association Dues 29.4% of $216,426 = $63,629.24 American Hospital Association Dues 14.1% of $38,812 = $5,472.49 10948405 10948405 176188253 73656484 102531769 300873791 224457422 76416369 8949458 4516684 4432774 194329317 Due from Affiliate 3900929 Estimated 3rd Party Payor Settlements 739862 Right of Use Assets 35358429 Due from Foundation 180372 40179592 Due to Affiliate 17088174 Professional Liability and Legal Settlements 4456000 Right of Use Liabilities 37560077 59104251 X 951694895 31656123 291179993 322836116 628858779 706074 706074 629564853 905838378 284582302 284582302 621256076 706074 706074 621962150 Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Change in Beneficial Interest in Assets Held by Foundation 1,866,374. Confluence Health System Revenues Reported in Separate Form 990 139,024,254. Wenatchee Valley Hosptial Revenues Reported in Separate Form 990 150,289,365. Part XII, Line 2d - Other Adjustments: Confluence Health System Expenses Reported in Separate Form 990 139,394,668. Wenatchee Value Hospital Expenses Reported in Separate Form 990 145,187,634. 1 1 X 1 X 1 X 1 1 1 0 0 9090000 9090000 0.01460 100734855 47642727 53092128 0.08540 109824855 47642727 62182128 0.10000 103573542 50579388 52994154 0.08520 103573542 50579388 52994154 0.08520 213398397 98222115 115176282 0.18520 1 18523577 124559609 190637795 -66078186 X 1 1 2 1 Confluence Health Hospital - Central Campus 1201 S Miller St Wenatchee WA 98801 www.confluencehealth.org HAC.FS.00000168 X X X 2 Confluence Health Hospital - Mares Campus 820 North Chelan Ave Wenatchee WA 98801 www.confluencehealth.org HAC.FS.00000168 X X X X X Confluence Health Hospital 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Part V, Page 8 0 0 1 X 200.000000000000 300.000000000000 X X X X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X 1 X 0 X X X X 1 X 0 0 Confluence Health Hospital Part V, Section B, Line 5: The Community Voice survey from the 2019 CHNA was used again in 2022 CHNA. The survey instrument used for this study is based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. The final survey instrument was developed by Confluence Health and PRC.To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey also was implemented as part of this process. A list of recommended participants was provided by Confluence Health; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation.The Survey was offered in English and Spanish and was administered by SurveyMonkey. Paper copies were provided at various organizations throughout the Region. The survey captured the opinions of the Health Community, the factors to improve health, the greatest risks to health and the behaviors in the Community that positively impacted or genitively affect Health. Confluence Health Hospital Part V, Section B, Line 6a: Wenatchee Valley Hospital Confluence Health Hospital Part V, Section B, Line 11: During the CHNA process, key informants were asked to rate the severity of a variety of health issues in the community. The following were the highest ranked issues: 1. Mental Health 2. Substance Abuse 3. Nutrition, Physical Activity & Weight 4. Diabetes 5. Heart Disease & Stroke 6. Cancer 7. Access to Healthcare Services 8. Infant Health & Family Planning 9. Potentially Disabling ConditionsThe Executive Leadership Team choose five of these needs to address in the implementation strategy: Mental Health, Diabetes, Heart Disease & Stroke, Access to Healthcare Services and Infant Health & Family Planning. However, during the current tax year, Confluence Health has taken the following actions to address all the areas of need in the CHNA report: 1.) Mental Health-Provided emergency and outpatient services for mental health patients. -Worked with 100% of community stakeholders to evaluate and improve access to mental health services. -Staffed a Sexual Assault nurse who is trained specifically to treat sexually assaulted patients.-Partnered with Catholic Charities to explore and implement best mental health practices in our community. -Participated in community suicide prevention activities with the Suicide Prevention Coalition of North Central Washington. -Offered and encouraged use of the Employee Assistance Program to help employees navigate various life changes.2.) Substance Abuse-Invested in and participated in programs that are community based which will target patients and community members, currently or at risk of opioid or alcohol abuse.3.) Nutrition, Physical Activity & Weight-Invested in and educated patients about proper nutrition and activity to reduce weight and chronic disease. -Provided registered dietitians to work with patients to achieve their health goals and designed personalized plans to improve nutrition. This included but was not limited to: oncology nutrition, eating disorders, disordered eating, mindful eating, weight management, pediatric nutrition, and diabetic nutrition. -Provided cooking classes to help patients learn basic cooking skills, recipes, and meal planning ideas to help manage diabetes, with, high blood pressure, high cholesterol and overall health.4.) Diabetes-Introduced primary care redesign with a focus on chronic disease management. The program had 66.94% of patients see reduced blood sugars. -Started using an electronic education and monitoring device to promote patient engagement with their disease.5.) Heart Disease and Stroke-Through a multidisciplinary approach, improved blood pressure control of our population of patients with hypertension by 66.69%. -Through a similar multidisciplinary approach to controlling patient populations with elevated cholesterol levels, 86% of patients in this population saw decrease cholesterol levels.6.) Cancer-Opened an oncology treatment center in Moses Lake, WA and has continued to see increased volume across their primary and secondary markets.7.) Access to Health Care Services-Increased the number of advanced practitioners across the system and as a result increased access by 26 days. -Changed how same day clinics operated to make appointments available and more focus on shifting schedules to online scheduling that improved access by 2.75%.8.) Infant Health and Family Planning-Continued to offer child birth education and breast feeding classes for all demographics regardless of ability to pay.9.) Potentially Disabling Conditions-Made services available to these patients in a cost effective manner, so that other negative health consequences, such as depression were mitigated. Confluence Health Hospital Part V, Section B, Line 13b: The Individual Financial circumstances stated in the written financial policy is to take into consideration the patient/guarantor's assets and their ability to pay. Confluence Health Hospital Part V, Section B, Line 13h: Compassionate care is generally considered only after all other financial resources available to the patient have been explored and exhausted. In order to qualify for compassionate care, the patient/guarantor must fully cooperate with the Hospital in exploring and applying for these resources. Other financial resources include but are not limited to: group or individual medical plans, secondary or supplemental insurance policies, worker's compensation, Medicare, Medicaid or medical assistance programs, other state, federal or military programs, third party liability situations (e.g. auto accidents or personal injuries), or any other situation in which another person or entity may have a legal responsibility to pay for the costs of medical services.Compassionate care for non-emergent services shall be limited to those residing with the hospitals designated service area, which is defined as the counties of Chelan, Douglas, Grant and Okanogan as well as the town of Othello. Non-emergent services shall be defined as those services which are not considered as an "emergency medical condition" under the policy's definition.Compassionate care shall be limited to "appropriate Hospital (physician)-based medical services" as defined in the policy. Elective or cosmetic procedures that do not meet the definition of appropriate as set forth in the WA Administrative Code (WAC) 246-453-010(7) are excluded as well as procedures done outside of the Hospital.In those situations, where appropriate primary payment sources are not available, or in certain situations when the primary payment source leaves a balance that is the patient's liability, patients will be considered for compassionate care under the policy.Other eligibility criteria includes circumstances that indicate severe financial hardship or personal loss. Part V, Section B, Line 7a https://www.confluencehealth.org/documents/2022-PRC-CHNA-Report-Confluence-Health_Cathy-Thomas.pdf Part V, Section B, Line 10a https://www.confluencehealth.org/documents/content/annual-reports/Confluence-Health-CHNA-Implementation-Plan-24-25.pdf Part V, Section B Line 16a:https://www.confluencehealth.org/patient-information/financial-assistance/charity-care/Line 16b:https://www.confluencehealth.org/documents/CCP_Application_English.pdfLine 16c:https://www.confluencehealth.org/patient-information/financial-assistance/charity-care/ 25 1 - Professional Building 933 Red Apple Rd Wenatchee WA 98801 Clinic, Optometry, and General Surgery 2 - Saddle Rock Building 1215 S Miller Rd Wenatchee WA 98801 Endocrinology, Rheumatology, and Pulmonary 3 - Home Health Building 731 N Chelan St Wenatchee WA 98801 Home Healthcare 4 - Anti-Coag Building 988 S Juniper Dr Moses Lake WA 98837 Clinic 5 - Behavorial Health Building - Moses Lake 966 S Juniper Dr Moses Lake WA 98837 Clinic 6 - Behavorial Health Building - Wenatchee 630 N Chelan Ave Suites A7 and B7 Wenatchee WA 98801 Clinic 7 - Brewster Clinic 418 W Main Ave Brewster WA 98812 Clinic 8 - Cashmere Clinic 303 Cottage Ave Cashmere WA 98815 Clinic 9 - East Wenatchee Clinic 100 Highline Dr East Wenatchee WA 98802 Lab Services, Walk-In, Clinic 10 - Ephrata Clinic 314 Basin St SW Ephrata WA 98823 Clinic 11 - Haug Building 707 N Emerson Ave Wenatchee WA 98801 Clinic 12 - Methow Valley Clinic 1116 WA-20 Winthrop WA 98862 Clinic 13 - Miller Street Complex 1000 N Miller St Wenatchee WA 98801 Rehab Services, Spine Clinic 14 - Moses Lake Campus 840 E Hill Ave Moses Lake WA 98837 Lab Services, Walk-In, Clinic 15 - Moses Lake Radiation Oncology Center 905 E Hill Ave Moses Lake WA 98837 Clinic, Lab Services 16 - Moses Lake Specialty Care Services 1345 Yonezawa Blvd Moses Lake WA 98837 Clinic 17 - Occupational Medicine 317 N Mission St Wenatchee WA 98801 Clinic 18 - Omak Campus 916 Koala Dr Omak WA 98841 Lab Services, Walk-In, Clinic 19 - Regional Eye Center 717 Okoma Dr Omak WA 98841 Regional Eye Center 20 - Research Building 804 N Emerson Ave Wenatchee WA 98801 Research 21 - Royal City Clinic 103 Camelia St NW Royal City WA 99357 Clinic 22 - Smith Building 803 N Emerson Ave Wenatchee WA 98801 Clinic 23 - Tonasket Clinic 17 S Western Ave Tonasket WA 98855 Clinic, Lab Services 24 - Waterville Clinic 117 S Chelan Ave Waterville WA 98858 Clinic 25 - Wenatchee Orthopedics Building 520 N Chelan Ave Wenatchee WA 98801 Clinic Part I, Line 3c: Central Washington Hospital may write off as charity care, amounts for patients with family income in excess of 300% of the federal poverty level when circumstances indicate severe financial hardship or personal loss. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b and subsidized health services line 7g was calculated using the costing methods to prepare the cost reports. Part III, Line 2: The hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 4: The footnote to the organization's financial statements addressing implicit price concessions may be found on page 14-15 of the attached audited financial statements. Part III, Line 8: Even though Medicare was at a loss, the Association continues to provide services to these patients because access to healthcare and individual's health is important. Therefore, the Association considers the Medicare shortfall a community benefit. Part III, Line 9b: Steps taken to collect an outstanding balance are: 1. Statements will generate every 30 days for any account that has an outstanding self-pay balance. All statements include information about Confluence Health's financial assistance and charity care program, along with contact information for Confluence Health's Charity Care Representatives. 2. At 30-60 days if no payment has been made, Confluence Health will make reasonable efforts to contact the guarantor regarding their outstanding balance. a. If no communication has been received, a phone call may be attempted to begin working with the guarantor. If the guarantor cannot be reached a letter will be sent. b. The guarantor will be advised of the availability of all payment plan options, bank financing, sliding scale discounts, and Confluence Health's financial assistance and charity care program. i. When a guarantor is being screened for eligibility for Confluence Health's financial assistance and charity care program, all collection efforts on unpaid balances will cease pending a final determination. 3. At 90 days past due, further collection efforts will commence. a. Attempts will be made to contact the guarantor by phone and through letter correspondence until the account reaches 120 days past due. b. The guarantor will be advised of the availability of all payment plan options, bank financing, sliding scale discounts, and Confluence Health's financial assistance and charity care program. i. When a guarantor is being screened for eligibility for Confluence Health's financial assistance and charity care program, all collection efforts on unpaid balances will cease pending a final determination. 4. At 120 days past due, the account will be referred to an outside collection's agency. a. If at any point during the collection process the guarantor requests that they be screened for Confluence Health's financial assistance and charity care program, collection activity will cease until a final determination is made.The collections policy applies to patients with charity care eligible charges as follows: Patients with an FPL that qualifies them for free care, adjusted for family size, are not subject to collection efforts as their charges have been discounted at a rate of 100%. Patients with an FPL that qualifies them for discounted care, adjusted for family size, are responsible for the remaining self-pay balance owed after the appropriate charity care adjustment(s) have been applied. This remaining self-pay balance is subject to the collection activity outlined in Confluence Health's collection policy. Part VI, Line 2: Confluence Health Hospital participated in a Community Wide Needs Assessment in cooperation with Wenatchee Valley Hospital prior to the merger of the organizations in July 2023. Part VI, Line 3: Information about the Confluence Health's financial assistance and charity care policy also known as Compassionate Care Program (CCP) shall be made publicly available as follows:1. A notice advising patients that the hospital provides compassionate care shall be posted in key public areas of the facility.2. The hospital will distribute a written notice about the availability of compassionate care to all patients at the time of new patient registration through the emergency department and during admissions. This information will also be available on the website, with each billing statement, and in any collection letters sent by the association.3. The written notice shall be available in any language spoken by more than five percent of the population in the association's service area, and interpreted for other non-English speaking or limited-English speaking patients and for other patients who cannot understand the writing and/or explanation. The association's service area is defined as; Chelan, Douglas, Okanogan and Grant counties. The association finds that following non-English translation(s) of the notice shall be made available: Spanish, Russian, and Ukraine.4. The hospital will refer all compassionate care inquiries to the financial assistance department or when possible directly to the compassionate care coordinator so that all concerns can be addressed in a timely manner.5. Written notice about the hospital's compassionate care policy shall be made available to any person who requests the information, either by mail, by telephone or in person. The hospital's compassionate care sliding scale discount table shall also be made available upon request. Part VI, Line 4: Confluence Health is an integrated healthcare delivery system that serves as the major medical provider in North Central Washington between Seattle and Spokane. With approximately 300 physicians, 170 advanced practice providers, 30 medical specialties, two hospitals and primary care services, Confluence Health provides high-quality, compassionate, cost-effective care close to home. Confluence Health is a not-for-profit institution governed by a board of directors, providing general inpatient services including medical, surgical, home infusion services, intensive care and coronary care, neonatal intensive care, pediatrics, obstetrics, gynecology, and oncology.Confluence Health Hospital-Central Campus is a 198-bed acute care hospital, federal regional referral center, and is designated by the state as a Level III general trauma center and Level III pediatric trauma center, supported by a comprehensive range of surgical procedures in orthopedic, neurosurgery, vascular surgery, interventional cardiac catheterization, and open-heart surgery.Confluence Health Hospital - Mares Campus includes an ambulatory center, 11 patient care beds, 9 rehab patient beds, and multiple outpatient care facilities spread through 4 counties.Wenatchee, Washington is approximately 150 miles east of Seattle, Washington and 170 miles west of Spokane, Washington. Chelan and Douglas counties comprise the Association's primary service area while Grant and Okanogan counties represent secondary service areas. Approximately 96% of Confluence's patient admissions are from the primary and secondary service areas. The service area's population is heavily weighted in the 65+ age cohort. In addition, the area has a high concentration of farm and agriculture related employers/employees. Part VI, Line 5: Confluence Health Hospital's governing board is comprised of local central Washington residents. The hospital extends its medical staff privileges to all qualified physicians in the community. CWH uses its income to update equipment, technology and facilities to improve patient care. The hospital offers education for area physicians and community members. In addition, it has the Heminger health library available to physicians and the community. Confluence collaborates with many local and state colleges, universities, and our local high school in support of student learning opportunities. An electronic medical record was recently implemented, giving our providers all the medical information needed to make the best decisions in the care of our patients. The hospital is a federal regional referral center and a Level III general and pediatric trauma center. Part VI, Line 6: Confluence Health System was formed as a health system that represented an affiliation between Central Washington Health Services Association, dba Central Washington Hospital (the Association) and Wenatchee Valley Medical Group. Effective January 1, 2013, the Association affiliated with Confluence Health System, and Confluence Health System became the sole member of the Association. The affiliation was completed in 2013, and Wenatchee Valley Medical Group transferred its remaining nonphysician employees and its operations to Wenatchee Valley Hospital, at which time Confluence Health become the sole member of Wenatchee Valley Hospital. Effective July 1, 2023, the three affiliated entities; Central Washington Health Services Associaton, Wenatchee Valley Hospital and Confluence Health System merged into a single entity, Central Washington Health Services Association (dba Confluence Health). Confluence Health contracts with WVMG for physician services. The Board of Directors of Confluence Health consists of 9 community members and 6 physicians of Wenatchee Valley Medical Group.The mission statement of Confluence Health is: Dedicated to improving our patients' health by providing safe, high-quality care. 1 Confluence Health Foundation 526 N Chelan Ave Suite A Wenatchee WA 98801 911075950 501(c)(3) 278112 0 General Support Young Men's Christian Association 217 Orondo St Wenatchee WA 98801 910578224 501(c)(3) 100000 0 General Support Wenatchee Valley College 1300 Fifth St Wenatchee WA 98801 910817705 501(c)(3) 12000 0 General Support Community Foundation of NCW 9 S Wenatchee Ave Wenatchee WA 98801 911349486 501(c)(3) 319969 0 General Support People for People 302 W Lincoln Ave Wenatchee WA 98801 910783225 501(c)(3) 33000 0 General Support 5 0 Breast, Cervical, and Colon Cancer Screening Program 17 10552 HIV Prevention and Care Program 94 56235 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 1 1 X X 1 0 0 0 0 0 0 0 0 Glenn Adams Chief Operations Officer (thru June) 208888 0 0 0 772825 0 16500 0 22459 0 1020672 0 0 0 Andrew Jones MD Chief Executive Officer 778694 0 75 0 0 0 16500 0 38758 0 834027 0 0 0 Tom Legel Chief Financial Officer 541934 0 75 0 59942 0 16500 0 32805 0 651256 0 0 0 Katina Maier Chief People & Strategy Officer 485062 0 75075 0 0 0 16500 0 16077 0 592714 0 0 0 Jason Lake MD Chief Medical Officer (thru Sept) 413047 0 100685 0 0 0 16500 0 37301 0 567533 0 0 0 Jonathan Stoever MD Physician 445838 0 0 0 0 0 16500 0 36008 0 498346 0 0 0 Tracey Kasnic Former Key CNO/Hospital Administrator (thru Jul 216440 0 0 0 223805 0 13801 0 11870 0 465916 0 0 0 Robert Pageler Chief Information Officer 424296 0 75 0 0 0 16500 0 17626 0 458497 0 0 0 Kris Deyerle VP General Counsel 366864 0 75 0 12987 0 16500 0 28553 0 424979 0 0 0 Kelly Allen Chief Nursing Officer 317045 0 75 0 0 0 15788 0 16791 0 349699 0 0 0 Eric Caldwell VP, Finance 264349 0 75 0 0 0 13549 0 35531 0 313504 0 0 0 Mauvia Sorensen ARNP - Behavior Health 271356 0 75 0 0 0 13875 0 26973 0 312279 0 0 0 Jay Johnson VP Managed Care & Gov 259637 0 75 0 9615 0 13338 0 29250 0 311915 0 0 0 Thomas Christensen VP of Human Resources 236191 0 0 0 40000 0 11662 0 2880 0 290733 0 0 0 Sarah Battis Johnson Former Key) VP Quality Care Transformation 221446 0 75 0 22096 0 12213 0 28562 0 284392 0 0 0 Staci Jones Former Key VP Sr Specialty Care 232693 0 75 0 0 0 11485 0 18320 0 262573 0 0 0 Joellen Colson Former Key VP Ancillary Services 96028 0 0 0 13084 0 5357 0 20594 0 135063 0 0 0 Part I, Line 1a Employees receive a $50 monthly stipend for a gym membership. This is treated as taxable income for the individuals. Part I, Line 4a Glenn Adams received a severance payment of $704,839 in 2023. Tracey Kasnic received a severance payment of $160,000 in 2023. Form 990, Part VII, Section A, Line 5 Compensation of $567,533 was paid for Dr. Jason Lake by an unrelated third party, Wenatchee Valley Medical Group, LLC, for services performed for Confluence Health. A Washington Health Care Facilities Authority 911108929 93978HPZ2 2015-05-05 109863859 To refund bonds issued 8/12/09 0 0 0 B Washington Health Care Facilities Authority 911108929 000000000 2020-02-27 40000000 Inpatient/Outpatient Facility & Parking Garage 0 0 0 A 12795556 109863859 1391468 108472392 0 1 1 1 B 1342474 40000000 488031 39511969 2020 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: Washington Health Care Facilities Authority Date the Rebate Computation was Performed: 06/06/2020 X 1 551000 Appraised Value 0 0 0 0 Part I, Column (b): Part I, Column B represents the number of contributions received. Form 990, Part III, line 2 Effective July 1, 2023, the three affiliated entities (Confluence Health System, Central Washington Health Services Association, and Wenatchee Valley Hospital) merged into a single entity, Central Washington Health Services Association (dba Confluence Health.) Assets and liabilities were transferred at their carrying amounts as the entities were previously under common control. Form 990, Part VI, Section A, line 2 For the first six months of the year, Central Washington Health Services Association , Confluence Health System, and Wenatchee Valley Hospital boards included the same members. As such, all board members had a business relationship. In addition, some board members are minority owners in an entity that has a professional services agreement with Confluence Health and therefore have a business relationship. Form 990, Part VI, Section A, line 4 The articles of incorporation were restated in June of 2023, as the affiliated entites merged into a single entity. The bylaws were amended in June 2023 to eliminate the single member and to change the election of board members from the single member to the board's vote,. Form 990, Part VI, Section A, line 6 From January to June, the sole member of the organization was Confluence Health System. The articles were amended and there is no longer any member. Form 990, Part VI, Section A, line 7a From January to June, the sole member selected the board of directors in accordance with the composition requirements in the bylaws. After the Articles were amended, the board is a self-perpetuating board. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing board. Form 990, Part VI, Section B, line 11b A copy of the Form 990 is reviewed by the Chief Financial Officer and Vice President of Finance. Subsequent to this review, the Form 990 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 a conflict of interest questionnaire. The board reviews questionnaires of existing and new members for potential conflicts of interest. Any potential conflicts of interest are resolved by the board The executive team reviews questionnaires submitted by the 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. 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 The Organization's governing documents, conflict of interest policy, and audited financial statements are available to the public upon request. Form 990, Part IX, line 11g Professional Services: Program service expenses 133,266,104. Management and general expenses 14,433,935. Fundraising expenses 0. Total expenses 147,700,039. Form 990, Part XI, line 9: Change in Beneficial Interest in Assets Held By Foundation 1,866,374. Net Assets Transfer -5,249,257. Confluence Health 1201 South Millre St Wenatchee WA 98801 454789950 Health System WA 501(c)(3) Line 12c, III-FI N/A 0 Wenatchee Valley Hospital 820 North Chelan Ave Wenatchee WA 98801 455563741 Hospital WA 501(c)(3) Line 3 Confluence Health 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 Schedule R, Part II: Effective July 1, 2023, Confluence Health System and Wenatchee Valley Hospital were merged into a single entity, Central Washington Health Services Association (dba Confluence Health).