2024-06-10T15:44:21-05:00 2023-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2023-01-01 814552945 SUNNYSIDE HOME HEALTH SUNN 5098371500 812 MILLER AVE SUITE A SUNNYSIDE WA 98944 MAXWELL OWENS CFO 5098371500 2024-06-06 1 MAXWELL OWENS 999009999 0 COLLEEN RAMIRES P01251320 4252597227 2024-06-06 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z ASTRIA HOME HEALTH BRIAN GIBBONS 812 MILLER AVE SUITE A SUNNYSIDE WA 98944 914844 0 X N/A X 2017 WA DELIVER QUALITY HOME HEALTH SERVICES, EDUCATIONAL AND OTHER ACTIVITIES TO PROMOTE HEALTH. 8 5 0 6 0 0 3801 0 1054421 914844 0 0 0 0 1058222 914844 0 0 0 0 470613 402371 0 0 0 178083 187523 648696 589894 409526 324950 745182 1071362 3231 4461 741951 1066901 TO DEVELOP AND MAINTAIN ACTIVITIES AND PROGRAMS TO DELIVER QUALITY HOME HEALTH SERVICES, EDUCATIONAL PROGRAMS AND OTHER ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH, REHABILITATION AND SOCIAL NEEDS OF INDIVIDUALS IN NEED WITHIN THE COMMUNITY. 0 0 567096 914844 PROVIDE HOME HEALTH SERVICES TO THE COMMUNITY. A TOTAL OF 4,074 VISITS FOR 120 INDIVIDUAL CASES. 567096 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MAX OWENS 5098371379 1016 TACOMA AVE SUNNYSIDE WA 98944 DAVID SHOEMAKER BOARD MEMBER 1.00 39.00 X 0 851432 29208 BRIAN GIBBONS CEO 1.00 39.00 X X 0 841777 57034 MAXWELL OWENS CFO 1.00 39.00 X 0 652831 30174 ANA GARCIA BOARD MEMBER 1.00 39.00 X 0 506299 43034 CHRISTINA RIVAS BOARD CHAIR 1.00 1.00 X X 0 0 0 SUZY FONSECA BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 JAY RODNE BOARD SECRETARY/TREASURER 1.00 1.00 X 0 0 0 JONATHAN G MERCER BOARD MEMBER 1.00 2.00 X 0 0 0 BRYAN SANDLIN BOARD MEMBER 1.00 1.00 X 0 0 0 PEGGY BREWER BOARD MEMBER (THRU 10/23) 1.00 2.00 X 0 0 0 0 2852339 159450 0 0 1 0 0 NET PATIENT REVENUE 624100 914844 914844 914844 914844 914844 0 0 359513 359513 9519 9519 2420 2420 30919 30919 9148 9148 13650 13650 2314 2314 5845 5845 35314 35314 PURCHASED SERVICES 84364 84364 MEDICAL SUPPLIES 21534 21534 15354 15354 589894 567096 22798 0 225275 305632 519907 765730 745182 1071362 3231 4461 3231 4461 X 741951 1066901 741951 1066901 745182 1071362 324950 0 X 0 1 X 1 0 X 0 DUE FROM AFFILIATES 765730 765730 X PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515, AND SEVERAL LIMITED LIABILITY COMPANIES. THE ORGANIZATION HAS ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS, WHICH IS AN ACCOUNTING STANDARD THAT PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2023. 0 0 0 0 0 0 0 0 0 DAVID SHOEMAKER BOARD MEMBER 0 655647 0 189130 0 6655 0 13200 0 16008 0 880640 0 0 BRIAN GIBBONS CEO 0 481943 0 355666 0 4168 0 13200 0 43834 0 898811 0 0 MAXWELL OWENS CFO 0 374726 0 271708 0 6397 0 13200 0 16974 0 683005 0 0 ANA GARCIA BOARD MEMBER 0 434941 0 70718 0 640 0 13200 0 29834 0 549333 0 0 PART I LINE 3: THE ORGANIZATION CONTRACTS WITH ASTRIA HEALTH FOR MANAGEMENT SERVICES. ASTRIA HEALTH DETERMINES THE CEO SALARY. ASTRIA HEALTH ESTABLISHES SALARIES AT THE TIME OF HIRE AND PERIODICALLY REVIEWS THEM THEREAFTER. TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY-RELATED EXPERIENCE B) PREVAILING CEO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR BUSINESSES OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA; AND C) ASTRIA HEALTH'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY ASTRIA HEALTH'S BOARD OR A SUBCOMMITTEE THEREOF. IN ADDITION TO BASE SALARY, THE CEO MAY BE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON PERFORMANCE PARAMETERS ESTABLISHED BY ASTRIA HEALTH AND APPROVED BY THE ASTRIA HEALTH BOARD. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ASTRIA HEALTH (AH). AH, AS THE PARENT AND SYSTEM ENTITY, PROVIDES THE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT NON-PROFIT CORPORATE ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING MANAGEMENT OF: - EXECUTIVE ACTIVITIES - INFORMATION SYSTEMS - FINANCIAL OPERATIONS - HEALTH INFORMATION AND RECORDS - SCHEDULING AND REFERRALS - HUMAN RESOURCES - MATERIALS AND SUPPLIES - MEDICAL STAFF AND PHYSICIANS SERVICES - QUALITY RESOURCES - RISK MANAGEMENT - MARKETING AND COMMUNITY RELATIONS - SHARED SERVICES DIRECTORS FOR LABORATORY THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY AH: BRIAN GIBBONS $898,811 (COMPENSATION FOR SERVICES AS AN OFFICER OF AH AND RELATED TAX-EXEMPT ENTITIES) MAXWELL OWENS $683,005 (COMPENSATION FOR SERVICES AS AN OFFICER OF AH AND RELATED TAX-EXEMPT ENTITIES) FORM 990, PART VI, SECTION A, LINE 6 SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION DBA ASTRIA SUNNYSIDE HOSPITAL IS THE SOLE MEMBER OF SUNNYSIDE HOME HEALTH DBA ASTRIA HOME HEALTH. FORM 990, PART VI, SECTION A, LINE 7A SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION DBA ASTRIA SUNNYSIDE HOSPITAL AS THE MEMBER OF THE ORGANIZATION HAS SOLE AUTHORITY TO APPOINT THE ORGANIZATION'S BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION DBA ASTRIA SUNNYSIDE HOSPITAL AS THE MEMBER OF THE ORGANIZATION HAS SOLE AUTHORITY TO: - APPOINT OR REMOVE OFFICERS - OVERSIGHT AND APPROVAL OF OFFICER AND PHYSICIAN COMPENSATION - CHANGE THE MISSION AND PHILOSOPHY - ADOPT, AMEND OR REPEAL GOVERNING DOCUMENTS - ESTABLISH PARAMETERS AROUND AQUIRING OR DISPOSING OF ASSETS, INCURRING DEBT OR ENTERING LEASES - APPROVE ANY CORPORATE RESTRUCTURING INCLUDING MERGERS AND DISSOLUTIONS - APPROVE ANNUAL STRATEGIC PLANS AND CAPITAL BUDGETS - APPOINT AUDITORS - CAUSE THE ISSUANCE OR REDEMPTION OF A MEMBERSHIP TO OR FROM ANY PERSON OR ENTITY FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO ASTRIA HEALTH'S CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER PRIOR TO APPROVAL OF THE 990. A DRAFT IS ALSO DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO AUTHORIZES THE PREPARER TO FINALIZE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD FILLS OUT A CONFLICT OF INTEREST FORM DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR THROUGH SELF DISCLOSURE IN THE INTERIM. IF A POTENTIAL CONFLICT ARISES, THE AFFECTED PERSON SHALL FULLY DISCLOSE THE NATURE OF THE INTEREST AND WITHDRAW FROM DISCUSSION AND VOTING ON THE MATTER. ANY TRANSACTION OR VOTE INVOLVING A POTENTIAL CONFLICT OF INTEREST SHALL BE APPROVED ONLY WHEN A MAJORITY OF DISINTERESTED DIRECTORS DETERMINE THAT IT IS IN THE BEST INTEREST OF THE HOSPITAL TO DO SO. THE ORGANIZATION HAS A COMPLIANCE AND MONITORING POLICY THAT IS ENFORCED BY THE CEO. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - THE CEO IS EMPLOYED AND COMPENSATED THROUGH ASTRIA HEALTH, A RELATED ORGANIZATION. THE SALARY IS ESTABLISHED AT THE TIME OF HIRE, AND PERIODICALLY THEREAFTER, TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY RELATED EXPERIENCE. B) PREVAILING CEO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR HOSPITALS OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA. C) ASTRIA HEALTH'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY THE HOSPITAL BOARD OR A SUBCOMMITTEE THEREOF. THE CEO'S COMPENSATION WAS LAST REVIEWED IN 2023. LINE 15B - THE CFO'S COMPENSATION IS DETERMINED IN THE SAME MANNER AS THE CEO'S AND WAS LAST REVIEWED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 SUNNYSIDE HOME HEALTH DBA ASTRIA HOME HEALTH MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ASTRIA HEALTH 1016 TACOMA AVE SUNNYSIDE WA 98944 813973675 MANAGEMENT WA 501(C)(3) LINE 12C, III-FI N/A 0 ASTRIA SUNNYSIDE FOUNDATION DBA ASTRIA HEALTH FOUNDATION PO BOX 719 SUNNYSIDE WA 98944 912000867 FUNDRAISING WA 501(C)(3) LINE 12A, I SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION DBA ASTRIA SUNNYSIDE HOSPITAL 0 SHC MEDICAL CENTER - TOPPENISH DBA ASTRIA TOPPENISH HOSPITAL 1016 TACOMA AVE SUNNYSIDE WA 98944 814670687 HEALTHCARE WA 501(C)(3) LINE 3 SHC HOLDCO LLC 0 SHC MEDICAL CENTER - YAKIMA DBA ASTRIA REGIONAL MEDICAL CENTER 1016 TACOMA AVE SUNNYSIDE WA 98944 814656360 HEALTHCARE WA 501(C)(3) LINE 3 SHC HOLDCO LLC 0 SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION PO BOX 719 SUNNYSIDE WA 98944 911286274 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 AH NP8 1806 YAKIMA VALLEY HWY SUNNYSIDE WA 98944 831478789 HEALTHCARE WA 501(C)(3) LINE 3 ASTRIA HEALTH 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0