2024-05-13T13:17:26-05:00 2023-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-01-01 455563741 Wenatchee Valley Hospital WENA 5096638711 820 North Chelan Ave Wenatchee WA 98801 Thomas Legel Chief Financial Officer 5096638711 2024-05-13 1 Thomas Legel 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2024-05-13 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z X Thomas Legel 820 North Chelan Ave Wenatchee WA 98801 150289365 0 X www.confluencehealth.org X 2012 WA Dedicated to improving our patients' health by providing safe, high-quality care. X 15 9 0 120 0 0 732319 78000 281907232 150209984 60992 1381 0 0 282700543 150289365 270962 0 0 0 104531682 53326155 0 0 0 190445960 91861478 295248604 145187633 -12548061 5101732 111453369 0 127372683 0 -15919314 0 X We are dedicated to improving our patients' health by providing safe, high-quality care in a compassionate and cost-effective manner. 0 1 119203930 150209984 Wenatchee Valley Hospital was developed and formed as a means to further Confluence Health. The purposes of the hospital are as follows:A. Maintain the availability and access to high-quality, cost-effective healthcare services for the North Central Washington (NCW) community;B. Improve coordination of limited health care resources and maximize the efficiency of the health system to achieve the most cost effective care that can be delivered;(Continued on Sch. O)C. Preserve NCW community control over important care decisions and ensure NCW community involvement in the development of the medical infrastructure and oversight of the NCW community healthcare delivery system; D. Enhance the patient-physician relationship and maintain the high-quality of care and breadth of services the NCW community currently enjoys;E. Improve teamwork and integration across the continuum of care and ensure that physicians and other healthcare providers lead clinical designs and clinical decisions;F. Ensure that physicians and administrative leaders have a shared vision regarding the NCW community health care delivery system;G. Ensure that the NCW community economy, jobs, and business partners are preserved and can grow with the region in a responsible way;H. Develop a high performing integrated health care delivery system for the NCW community that could apply for and be successful with contracts from Medicare so that the newly created health system can be identified as an accountable care organization if so desired and position the health system so that it could contract for the overall system of care and be successful with newly developed risk contracts being offered by commercial insurers;I. Establish, equip, operate and maintain benevolent and charitable institutions for the giving of medical and surgical care to the sick, wounded and suffering irrespective of sex, marital status, disability, color, race, religious believe, sexual orientation, economic status, or pecuniary circumstances; andJ. Carry on any educational activities, related to the rendering of care to the sick and injured or the promotion of health which, in the opinion of the Board of Directors of WVH, may be justified by the facilities, personnel, funds, or other requirements that are or can be made available in accordance with the laws of the state of Washington. Wenatchee Valley Hospital operates ten rural health clinics in ten communities throughout the NCW community including: Wenatchee, Moses Lake, East Wenatchee, Cashmere, Tonasket, Oroville, Omak, Royal City, Waterville, and Brewster, as well as operates a 20-bed hospital facility which serves medical, surgical and rehabilitation patients. Wenatchee Valley Hospital has entered into professional service agreements with a multi-specialty physician group that employs or otherwise engages nearly 300 primary care physicians, physician specialists and mid-level practitioners to serve the needs of patients within the NCW community.Wenatchee Valley Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the association does not pursue collection of amounts determined to qualify as charity care they are not reported as revenue.The hospital system maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy and the estimated cost of those services and supplies. 119203930 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 9 1 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Thomas Legel 5096621511 1201 South Miller Street Wenatchee WA 98801 X Doug Shae Chair 2.00 4.00 X X 0 0 0 Cori Bautista Vice Chair 2.00 4.00 X X 0 0 0 Gus Heinicke Treasurer 2.00 4.00 X X 0 0 0 Abe Sorom MD Secretary 1.00 3.00 X X 0 0 0 Dave Balcom Board Member 1.00 3.00 X 0 0 0 Mabel Bodell MD Board Member 1.00 3.00 X 0 0 0 Garn Christensen Board Member 1.00 3.00 X 0 0 0 Jenny Cravens Board Member 1.00 3.00 X 0 0 0 Vanessa Gutierrez Board Member 1.00 3.00 X 0 0 0 Greg Hamilton Board Member 1.00 3.00 X 0 0 0 Jennifer Jorgensen MD Board Member 1.00 3.00 X 0 0 0 James Murray MD Board Member 1.00 3.00 X 0 0 0 Catherine Ridgeway MD Board Member 1.00 3.00 X 0 0 0 Vicky Scharlau Board Member 1.00 3.00 X 0 0 0 Michael Tuggy MD Board Member 1.00 3.00 X 0 0 0 Mitchell A Garrison Board Member (January) 1.00 3.00 X 0 0 0 Tom Tuszynski Board Member (January) 1.00 3.00 X 0 0 0 Andrew Jones MD Chief Executive Officer 15.00 35.00 X 0 0 0 Thomas J Legel Chief Financial Officer 15.00 35.00 X 0 0 0 Katina Maier Chief People Officer 15.00 35.00 X 0 0 0 Glenn W Adams Chief Operations Officer 15.00 35.00 X 0 0 0 Robert J Pagaler Chief Information Officer 15.00 35.00 X 0 0 0 Jason M Lake MD Chief Medical Officer 15.00 35.00 X 0 0 0 0 0 0 0 0 0 0 0 78000 78000 Net Patient Service Revenue 621990 146858407 146858407 Research 541700 1084625 1084625 Pharmacy 456110 487028 487028 Anicllary Services 900099 313047 313047 Cafeteria Revenue 722514 306126 306126 1160751 1160751 150209984 1381 0 1381 1381 1381 150289365 150209984 0 1381 X 39704279 39187577 516702 1821133 1725223 95910 8599217 8146338 452879 3201526 3032917 168609 23268 23268 68918164 47917476 21000688 1894484 1332029 562455 645599 392395 253204 573011 537676 35335 1517484 1270690 246794 1419385 1220123 199262 Medical Supplies 11382582 11333374 49208 Maintenance and Repairs 2140312 1288500 851812 Lease and Rental 1773118 1773118 Taxes and Licenses 1574071 46494 1527577 145187633 119203930 25983703 0 9045040 0 0 0 31534235 0 0 0 0 1859664 0 2748591 0 0 25300873 0 0 0 2000000 0 0 38964966 0 111453369 0 11118467 116254216 0 127372683 0 X -15919314 0 -15919314 0 111453369 0 X 5101732 10817582 X 0 0 0 X 1 1 X 1 X 175.000000000000 1 X 1 1 1 0 0 1854000 1854000 0.01280 12669368 7608401 5060967 0.03490 14523368 7608401 6914967 0.04770 34185467 26090693 8094774 0.05580 34185467 26090693 8094774 0.05580 48708835 33699094 15009741 0.10350 1 1266358 10944769 14860452 -3915683 X 1 1 1 1 Wenatchee Valley Hospital 820 North Chelan Ave Wenatchee WA 98801 www.confluencehealth.org HAC.FS.60424211 X X X X X Wenatchee Valley Hospital 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Part V, Page 8 X 1 23 1 See Part V, Page 8 0 1 X 175.000000000000 300.000000000000 X X X X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X 1 X 0 X X X X 1 X 0 0 Wenatchee Valley Hospital Part V, Section B, Line 5: In 2022, a 2022 Community Health Needs Assessment was conducted. The purpose of the Community Health Needs Assessment is to provide information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. This Community Health Needs Assessment will serve as a tool toward reaching three basic goals:To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life. To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors that historically have had a negative impact on residents' health. To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care. 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. Wenatchee Valley Hospital Part V, Section B, Line 6a: Central Washington Hospital Wenatchee Valley Hospital Part V, Section B, Line 6b: Aging and Adult care, Alateheia Riding Center, Americagroup, Ameircan Heart Association, America Red Cross-Apple Valley Chapeter, Apple valley Honda, Ballard Ambulance, Big Bend Community College, Cascade Medical Center, Cascade Medical Foundation, Cascade School District, Chelan County, Chelan County PUD, Chelan Douglas Casa, Chelan Douglas Regional Port Authority, Chelan Douglas Transportation Council, City of Cashmere, City of Chelan, City of East Wenatchee, City of Leavenworth, City of Waterville, City of Wenatchee, Columbia Basin Allied Arts, Columbia Basin Hospital, Colville Tribal Police Department, Confluence Health, Confluence Health Foundation, Ease Cancer Foundation, East Wenatchee Police Department, Epilepsy Foundation, Foundation for Youth Resiliency and Engagement, Grand Coulee School District, Grant County, Jeffers Danielson Sonn & Aylward, John L Scott Real Estate, KC-Help, Laura Mounter Real Estate, Manson School District, Mid Valley Hospital, Molina Healthcare, Moses Lake Community Health Center, Moses Lake Police Department, NCW Nurses Week, NCW Tech Alliance, North Central ACH, North Central Educational Services District, Okanogan Beahiovral Healthcare, Okanokan County, Okanogan County Community Action, Okanogan County Health District, Okanogan County Sheriff's Office, Okanogan County Transit, Okanogan Regional Humane, Okanogan School District, Omak School District, Orondo School District, Our Valley Our Future, Pateros Brewester Community Resource Center, Pateros School District, People for People, Port of Quincy, Rick Pankow Foundation, SAGE, Star Ranch, The Economic Alliance, Tierra Village, Together for Youth, Washington Apple Education Foundation, Washington State Tree Fruit Association, Washington State University Extension, Waterville School District, Wenatchee Downtown Association, Wenatchee Police Department, Wenatchee Valley College, Wenatchee Valley YMCA, YWCA. Wenatchee Valley Hospital Part V, Section B, Line 11: There were Nine significant needs identified in the 2022 CHNA:1. Mental Health2. Substance Abuse3. Nutrition, Physical Activity & Weight4. Diabetes5. Cancer7. Access to Healthcare Services8. Infant Health & family Planning9. Potentially Disabling ConditionsThe organization may not implement strategies for all of the health care issues, but the five most significant needs were highlighted, as discussed by the Executive Leadership Team:1. Mental Health2. Diabetes3. Heart Disease and Stroke4. Access to Healthcare Services5. Infant Health and Family PlanningPriority 1: Mental Health. Survey data indicates that residents in the Confluence Health Service area do not have adequate access to mental health care services and providers. 6.8% of total service area adults report difficulty accessing mental health services. Contributing factors identified include general lack of resources, lack of coordination of care, dual diagnosis for those with substance use disorders, affordable care, coordination between primary care providers and mental health providers, lack of community care and involvement, and stigma associated with seeking help for mental health issues. To address mental health, the Organization has implemented the following strategies. 1. Provide points of access for mental health services for the community. a. Confluence Health will continue to provide emergency and outpatient services for mental health patients. b. Confluence Health will participate with community stakeholder to evaluate and improve access to mental health services.c. Confluence Health will continue to staff a Sexual Assault Nurse Examiner (SANE) who is trained specifically to treat sexually assaulted patients.2 Improve access to mental and behavioral health partnerships.a. Confluence Health will continue to build upon its relationship with Catholic Charities to explore best practices for mental health care needs within our community.b. Confluence Health will continue to participate in community suicide prevention activities with the Suicide Prevention Coalition of North Central Washington.3 Provide a mental health support system for employees of Confluence Healtha. Confluence Health will continue to offer and encourage the Employee Assistance Program (EAP) to help employees navigate various life challengesPriority 2: Diabetes. More than 30 million people in the United States have diabetes. In our four counties, 12.8% of the adult population have been diagnosed with diabetes, another 8.3% have "pre-diabetes". The percent of our population with diabetes is significantly higher than our state average, especially in Chelan and Okanogan Counties. A lack of education plays a significant role. One public health representative stated there is a "lack of resources for individuals to learn how to care for themselves and resources to purchase supplies and fresh foods". This is echoed be a community leader, saying "Emphasis on education in early detection of the disease appears to be lacking." Addressing the problem before it starts is paramount in treating the growing diabetic population.The following priorities were implemented to address this need. 1. Improved Blood Sugar Control. a. In our primary care redesign, there is a focus on chronic disease management. One disease to be addressed is diabetes. Through this work, we will accomplish lower blood sugars for our patients.2. Patient Education and Engagement. a. Education and engagement will help patients with diabetes succeed in controlling their blood sugar. We will begin using an electronic education and monitoring device to promote patient engagement in their disease.Priority 3: Heart Disease and Stroke. Heart disease is the leading cause of death in the United States, and stroke is the fifth leading cause. North Central Washington is no exception. The morbidity and mortality of these two diseases impact many of our population. A focus on improved prevention of both with have a significant impact on our population's lives. Uncontrolled hypertension and high cholesterol are leading attributable factors to both heart disease and stroke. Management of blood pressure control requires education on a healthy lifestyle, dietary changes, appropriate medication usage and medication compliance. Not dissimilar to hypertension, high cholesterol can be improved with the same levers. Ongoing management of both would have a profound effect on our rates of heart disease and stroke in our areas.The Organization implemented the following strategies to address this need. 1. Controlling Hypertension. a. Through a multidisciplinary approach, improve the blood pressure control of our population of patients with hypertension.2. Controlling Hyperlipidemia and Preventing Stroke. a. Similar to hypertension, use a multidisciplinary approach to controlling elevated cholesterol levels.Priority 4: Access to Healthcare Systems. Many people in the United States don't get the healthcare services they need, and our communities experience the same issues. A total of 42.1% of adults in our four-county service area reported some difficulties obtaining health care in the past year. This percentage was higher than the national average for the four-county region, with Douglas County reporting the lowest response and Okanogan County the highest at 33.8% and 48.7%, respectively.To address these two major issues for the community, Confluence Health has started an initiative to redesign our Primary Care services and will be focusing on upcoming specialty services in the coming years. This work focuses on, among other things, optimizing our workforce to meet the growing needs of patients in the community. Finding the right mix of providers for the growth and developing a care team model to meet the needs of patients. In addition, the redesign efforts will improve scheduling availability for patients and our digital transformation efforts are moving this availability to more places for patients to reach. Increased utilization of MyChart and online scheduling will make processes easier for patients to access care.The Organization has implemented the following strategies.1. Optimizing our Provider Workforcea. Through our redesign efforts, there will be a focus on increasing the number of advanced practitioners across our service area. The redesign's focus is on stratifying patient populations to ensure the right care for the right patient by the right provider types. This should increase the ability to find a provider for all patients in the service area.b. Another focus of the redesign work is to identify new pathways for care delivery across the service area. New strategic partnerships and care delivery models will increase the ability for patients to see a provider when they need and want to. These new models of delivery will also allow patients to do it locally with limited travel to care sites.2. Improving Schedule Availabilitya. Increasing the availability of online appointments. Changes in how same day clinics make appointments available and more focus on shifting schedules to online scheduling will improve the availability for patients.b. Our most effective tool for increasing availability through mechanisms such as FastPass or other automated offerings are through MyChart. Our focus in this work is to increase the percentage of users who see their care team > 3 times in a 12 month period. This will provide increased communication and availability. Wenatchee Valley Hospital Part V, Section B, Line 13b: The individual financial circumstances stated in the written financial policy is to take into consideration the patient/guarantor's assets and their ability to pay. Wenatchee Valley Hospital Part V, Section B, Line 13h: Compassionate care is generally considered only after all other financial resources available to the patient have been explored and exhausted. In order to qualify for compassionate care, the patient/guarantor must fully cooperate with the Hospital in exploring and applying for these resources. Other financial resources include but are not limited to: group or individual medical plans, secondary or supplemental insurance policies, worker's compensation, Medicare, Medicaid or medical assistance programs, other state, federal or military programs, third party liability situations (e.g. auto accidents or personal injuries), or any other situation in which another person or entity may have a legal responsibility to pay for the costs of medical services.Compassionate care for non-emergent services shall be limited to those residing with the hospitals designated service area, which is defined as the counties of Chelan, Douglas, Grant and Okanogan as well as the town of Othello. Non-emergent services shall be defined as those services which are not considered as an "emergency medical condition" under the policy's definition.Compassionate care shall be limited to "appropriate Hospital (physician)-based medical services" as defined in the policy. Elective or cosmetic procedures that do not meet the definition of appropriate as set forth in the WA Administrative Code (WAC) 246-453-010(7) are excluded as well as procedures done outside of the Hospital.In those situations, where appropriate primary payment sources are not available, or in certain situations when the primary payment source leaves a balance that is the patient's liability, patients will be considered for compassionate care under the policy.Other eligibility criteria includes circumstances that indicate severe financial hardship or personal loss. Part V Line 7a: https://www.confluencehealth.org/documents/2022-PRC-CHNA-Report-Confluence-Health_Cathy-Thomas.pdf Part V Line 10a: https://www.confluencehealth.org/about-us/annual-reports/ Part V Line 11 additional information: Priority 5: Infant Health and Family Planning. Women giving birth in the U.S. are more likely to face mistreatment, serious complications or death than people in any other high-income country. The risks are even greater for minority populations. Access to infant health and family planning have limited accessibility for underserved communities and additionally there can be of stigma in asking for help or resources. These can lead to limited planning for the birthing process and limited prenatal care.Although the birth rate in Washington State continues to decline, North Central Washington has a significant number of migrant women who give birth with inadequate prenatal care putting them at increased risk. Statistics include an increased rate of gestational hypertension, increased rates of gestational diabetes and those with socio-economic inequalities have significantly worse outcomes on a range of indicators. The Confluence Health service area have a higher than state average births to adolescent mothers, which is also associated with a lack of prenatal care. Survey participants felt that access to health and family planning is not accessible for underserved communities and that there is stigma associated with asking for these resources particularly in Hispanic and native American populations. Prenatal care in pregnant teens was identified by social services providers in the more rural counties of Okanogan and Grant Counties. Health providers in these areas support the need for adequate prenatal and postnatal care for all these populations.To address infant health and family planning, the Organization implemented the following strategies. 1. Teamwork and communication for patient-centered childbirth. a. Confluence Health will participate in TEAMBIRTH for all births to develop a birthing plan for mothers, their support person and the care team to facilitate safe, dignified and respectful care.2. Education for expecting and new parents. a. Confluence Health will continue to offer childbirth education and breast-feeding classes for all demographics regardless of ability to pay. Part V Line 16a: https://www.confluencehealth.org/patient-information/financial-assistance/charity-care/elibility-ineligible-serivces/ Part V Line 16b: https://www.confluencehealth/patient-information/financial-assistance/charity-care/application-process/ Part V Line 16c: https://www.confluencehealth.org/patient-information/financial-assistance/cahrity-care/eligibility-ineligible-services/ 21 1 - Moses Lake Clinic 840 E Hill Ave Moses Lake WA 98837 Multispecialty clinic, ambulatory surgery center, walk-in clinic 2 - Omak Clinic and Regional Eye Center 916 Koala Drive Omak WA 98841 Multispecialty clinic, walk-in clinic 3 - East Wenatchee Clinic 100 Highline Drive East Wenatchee WA 98802 Family medicine, behavioral, lab & pathology, radiology/imaging 4 - Wenatchee Orthopedics Building 520 N Chelan Ave Wenatchee WA 98801 Othorpedics clinic 5 - Miller Street Complex 1000 N Miller St Wenatchee WA 98801 Physical therapy and sleep center 6 - Brewster Clinic 418 W Main Street Brewster WA 98812 Family medicine/primary care, cardiology, dermatology, & ear/nost/throat 7 - Pediatrics Building 900 N Mission Street Wenatchee WA 98801 Outpatient pedicatrics 8 - Tonasket Clinic 17 South Western Ave Tonasket WA 98855 Family medicine and primary care clinic 9 - Occupational Medicine 317 N Mission Street Wenatchee WA 98801 Occupational medicine 10 - Moses Lake Therapy Services Building 938 W 3rd Ave Moses Lake WA 98837 Physical therapy 11 - Ephrata Clinic 314 Basin SW Ephrata WA 98823 Family medicine/primary care, diagnostic & therapeutic services 12 - Methow Valley Clinic 1116 WA-20 Winthrop WA 98862 Family medicine and pediatrics 13 - Cashmere Clinic 303 Cottage Avenue Cashmere WA 98815 Family medicine and primary care clinic 14 - Oroville Clinic 1617 Main St Oroville WA 98844 Family medicine and primary care clinic 15 - Stemilt Clinic 2833 Euclid Ave Wenatchee WA 98801 Stemilt primary care clinic 16 - Behavioral Health Building 966 S Juniper Dr Moses Lake WA 98837 Behavioral health services 17 - Samaritan Clinic 1550 S Pioneer Way Moses Lake WA 98837 Ophthalmology, optometry, and rehabilitation 18 - Watervillle Clinic 117 South Chelan Ave Waterville WA 98858 Family medicine and primary care clinic 19 - Royal City Clinic 103 Camelia St NW Royal City WA 99357 Family medicine and primary care clinic 20 - Anti-Coag Building 986 S Juniper Dr Moses Lake WA 98837 Anticoagulation 21 - Moses Lake Specialty Care Clinic 1345 Yonezawa Blvd Moses Lake WA 98837 General & vascular surgery, optometry Part I, Line 3c: Confluence Health may write off as charity care, amounts for patients with family income in excess of 300% of the Federal poverty level when circumstances indicate severe financial hardship or personal loss. Part I, Line 7: 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: Wenatchee Valley 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 Hospital continues to provide services to these patients because access to healthcare and individual's health is important. Therefore, the Hospital considers the Medicare shortfall a community benefit. Part III, Line 9b: It is the policy to work with the patient to obtain payment in full, secure financial assistance, or establish appropriate payment arrangements on patient balances within 30 days of the initial statement date.1. When possible, the scheduler, and/or receptions, will alert the patient of any self-pay deposit, pre-payment or insurance co-payment, which may be requested at the time of service.2. Payment in full on all self-pay balances is expected within 30 days of receipt of the first statement. The responsibility for payment remains with the guarantor. The Hospital does not become involved in disputes that occur as a result of divorce settlements, child custody, and accidental injury or third party litigation.3. Working with the guarantor, the Hospital will establish payment arrangements when payment in full cannot be made. Collection efforts are suspended when the guarantor requests a financial assistance application. This suspension is in effect for 30 calendar days giving the appropriate party time to complete the application and provide the required documentation. Collection efforts remain suspended until the final determination of qualification is completed.4. All transactions are required to age a minimum of 120 days, allowing for 4 statements and at least 1 letter, before being considered for transfer to an outside collection agency.5. If an account has a mail return status and all steps taken to find the address were unsuccessful the account may be turned to collection for further research. Part VI, Line 2: Wenatchee Valley Hospital participated in a Community Wide Needs Assessment in cooperation with Action Health Partners, Chelan-Douglas Health District, Cascade Medical Center, and Confluence Health. Part VI, Line 3: Communications to the public: information about the hosptial'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 hospitals's service area is defined as; Chelan, Douglas, Okanogan and Grant counties. The hospital finds that following non-English translation(s) of the notice shall be made available: Spanish.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 association's compassionate care policy shall be made available to any person who requests the information, either by mail, by telephone or in person. The hospital's compassionate care sliding scale discount table shall also be made available upon request. Part VI, Line 4: The Hospital operates a 20-bed hospital along with 13 multispecialty outpatient clinics delivering a full range of health care services in Wenatchee, Washington and the North Central Washington area. The Hospital is a not-for-profit institution governed by a board of directors, providing general inpatient and rehab services as well as allergy, audiology, behavioral medicine, breast & cervical health, breast imaging, cancer care, cardiology, cardiothoracic surgery, dermatology, ear, nose & throat, endocrinology, family medicine, gastroenterology, geriatrics, hospital services, infectious disease, internal medicine, nephrology, neurology, neurosurgery, nutrition, occupational medicine, occupational therapy, oncology & hematology, ophthalmology, optometry, orthopedics & orthopedic surgery, pain management, palliative care, pediatrics, physiatry, physical therapy, podiatry, pulmonary medicine, radiation oncology, radiology/imaging, research, rheumatology, robotic surgery, sleep center, speech language pathology, spinal clinic & surgery, urology, vascular surgery, women's health and wound care.The Assoication is a 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 comprehansive range of surgical procedures in orthopedic, neurosurgery, vascular surgery, interventional cardiac catherization and open-heart surgery. Wenatchee, Washington is approximately 150 miles east of Seattle, Washington and 170 miles west of Spokane, Washington. Chelan and Douglas counties comprise the hospital's primary service area while Grant and Okanogan counties represent secondary service areas. The 13 multispecialty outpatient clinics are located in 11 cities. Approximately 96% of the Hospital's patient visits are from the primary and secondary service areas. The service area's population is heavily weighted in the 65+ age cohort. In addition, the Hospital has a high concentration of farm and agriculture related employers/employees. Part VI, Line 5: The Hospital partners with Confluence Health to serve the health of the community by providing benefits to the community including educational opportunities, clinics, and flu vaccinations. Part VI, Line 6: Confluence Health was formed in 2012 as a health system that represents an affiliation between the Hospital, Wenatchee Valley Medical Group (a for-profit organization) and Central Washington Hospital. Effective January 1, 2013, the Hospital affiliated with Confluence Health and Confluence Health became the sole member of the Hospital. The board of directors of Confluence Health consists of 9 community members and 6 physicians of Wenatchee Valley Medical Group.The mission statement of Confluence Health is:We are dedicated to improving our patients health by providing safe, high-quality care in a compassionate and cost-effective manner. Cash and Cash Equivalents 2023-06-30 15312451 General Ledger 454789950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) Accounts Receivable 2023-06-30 58568610 General Ledger 454788950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) Prepaid Expenses 2023-06-30 1564904 General Ledger 454789950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) Inventory 2023-06-30 10046 General Ledger 454789950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) Fixed Assets 2023-06-30 24887564 General Ledger 454789950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) Right of Use Assets 2023-06-30 32105462 General Ledger 454789950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) Other Assets 2023-06-30 5900929 General Ledger 454789950 Confluence Health 1201 S Miller St Wenatchee WA 98801 501(c)(3) 1 1 0 0 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: See Form 990, Part VII for the listing of persons involved. Part I, Line 2e: Explanation of Involvement: The organization and transferee organization share a common list of officers and board members. Form 990, Part III, line 3 The organization merged with with Confluence Health effective 06.30.2023. Form 990, Part VI, Section A, line 1a Any committee, to the extent provided in the resolution of the Board, will have and may exercise any of the powers and authority of the Board, except that committees shall not have any power or authority as to the following: (i) electing, appointing, or removing any member of any such committee or any Board Member or officer of WVH; (ii) amending, altering or repealing of the Bylaws; (iii) amending, altering or repealing of the articles of incorporation; (iv) adopting a plan of merger or adopting a plan of consolidation with another corporation; (v) authorizing the sale, lease, or exchange of all or substantially all of WVH's property and assets not in the ordinary course of business; (vi) authorizing WVH's voluntary dissolution or revoking proceedings therefor; (vii) adopting a plan for the distribution of WVH's assets; (viii) amending, altering, or repealing any Board resolution which by its terms provides that it shall not be amended, altered, or repealed by such committee; (ix) the fixing of Board Members' compensation; or (x) action on matters committed by the Bylaws or by Board resolution to another Board committee. The designation and appointment of any such committee and the delegation thereto of authority shall not operate to relieve the Board of Directors, of any individual Board Member, of any responsibility imposed upon him or her by law. The standing committees of the Board of Directors (the "Standing Committees") shall include a Quality Enhancement and Safety Committee, an Audit and Enterprise Risk Management Committee, and a Governance and Strategic Planning Committee having such powers and duties delegated by the Board that are not inconsistent with Section 3 hereof or any existing delegation of powers to a committee of Board Members. Standing Committees shall have at least one Clinic Member and one Community Member. Form 990, Part VI, Section A, line 2 Confluence Health and Affiliates share the same Board as part of the operating structure. As such, all board members serve with each other in a similar capacity on related organizations. Additionally, some board members are minority owners in an entity that has a professional services agreement with Confluence Health. Form 990, Part VI, Section A, line 4 The board of directors approved Articles of Merger on June 30, 2023. Form 990, Part VI, Section A, line 6 The sole member is Confluence Health. Form 990, Part VI, Section A, line 7a Upon the expiration of the term of office of any Board member, including each of the initial Board members set forth by the bylaws, the Board of Directors of Confluence Health shall select the person who shall fill the position of the Board member whose term is expiring, subject to the composition requirements for the Board of Directors as set forth in the bylaws. The persons selected by the Board of Directors of Confluence Health to fill the position of the Board member whose term is expiring shall be of the highest competence and quality who are without conflicts with Central Washington Hospital that would prohibit their serving in accordance with the bylaws and tax or other regulatory requirements. Form 990, Part VI, Section B, line 11b A copy of the Form 990 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 an annual questionnaire. The nominating committee of the board reviews questionnaires of existing and new members for potential conflicts of interest. Any potential conflicts of interest are resolved by the nominating committee. The executive team reviews questionnaires submitted by 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. Review of all conflict of interest statements is noted within the board minutes. Form 990, Part VI, Section B, line 15 The compensation committee of the governing board annually reviews independent salary survey information and recommends a salary and/or a salary increase for the CEO to the governing board. The other officers receive an annual percent increase which non-contractual employees receive unless the CEO awards a different percentage. The amount is, typically, based on current CPI, market and salary survey information. Form 990, Part VI, Section C, line 19 Wenatchee Valley Hospital's governing documents, conflict of interest policy and audited financial statements are available to the public upon request. Form 990, Part IX, line 11g Contract Labor: Program service expenses 2,255,094. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,255,094. Professional Fees: Program service expenses 39,979,001. Management and general expenses 20,770,844. Fundraising expenses 0. Total expenses 60,749,845. Purchased Services: Program service expenses 5,683,381. Management and general expenses 229,844. Fundraising expenses 0. Total expenses 5,913,225. Form 990, Part XI, line 9: Transfer of operations to Confluence Health 10,817,582. Form 990, Part IV, Line 20b: The organization merged into Confluence Health on June 30, 2023. The 2023 Form 990 is being filed for the six month period January 1, 2023 to June 30, 2023. There were no audited financial statements done for that short year. The audit from calendar year 2022 is the most recent audited financial statements and is attached to the return. Central Washington Health Services Association 1201 South Miller St Wenatchee WA 98801 910171250 Hospital WA 501(c)(3) Line 3 Confluence Health 0 Confluence Health 1201 South Miller St Wenatchee WA 98801 454789950 Health System WA 501(c)(3) Line 12c, III-FI N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0