2024-05-10T15:13:00-05:00 2023-06-30 135565207 KPMG LLP 401 UNION STREET SUITE 2800 SEATTLE WA 98101 990 2022-07-01 910939479 PEACEHEALTH PEAC 3607291000 1115 SE 164TH AVENUE VANCOUVER WA 98683 DARRIN MONTALVO EXEC VP 3607291000 2024-05-15 1 DARRIN MONTALVO 999009999 0 DAVID M HIGHFILL P01517891 2069134000 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DARRIN MONTALVO 1115 SE 164TH AVENUE VANCOUVER WA 98683 7259859724 0 X WWW.PEACEHEALTH.ORG X 1976 WA WE CARRY ON THE HEALING MISSION OF JESUS CHRIST. 11 11 20848 2001 0 0 116988641 37340264 3072066252 3261190664 89816646 32538094 12603722 13629230 3291475261 3344698252 4519629 4774908 0 0 2096479199 2109638846 0 0 1362119 1367368265 1441197469 3468367093 3555611223 -176891832 -210912971 4620922535 4683032130 2312470406 2420552040 2308452129 2262480090 X WE CARRY ON THE HEALING MISSION OF JESUS CHRIST BY PROMOTING PERSONAL AND COMMUNITY HEALTH, RELIEVING PAIN AND SUFFERING, AND TREATING EACH PERSON IN A LOVING AND CARING WAY. 0 0 2505185620 4774908 2817994853 HOSPITALS: FOUNDED BY THE SISTERS OF ST. JOSEPH OF PEACE, PEACEHEALTH HAS PROVIDED EXCEPTIONAL MEDICINE AND COMPASSIONATE CARE TO NORTHWEST COMMUNITIES FOR MORE THAN A CENTURY. PEACEHEALTH IS A NOT-FOR-PROFIT HEALTH CARE SYSTEM WITH HOSPITALS LOCATED IN ALASKA, WASHINGTON AND OREGON. RURAL COMMUNITIES RELY ON THEIR HOSPITALS AS CRITICAL COMPONENTS OF THE COMMUNITIES' ECONOMIC AND SOCIAL FABRIC. THESE HOSPITALS ARE TYPICALLY THE LARGEST OR SECOND LARGEST EMPLOYER IN THE COMMUNITY, AND OFTEN STAND ALONE IN THEIR ABILITY TO OFFER HIGHLY-SKILLED JOBS. (COMMENTARY CONTINUED ON SCHEDULE O.) 635325374 443195811 CLINICS AND MEDICAL GROUPS: IN ADDITION TO PROVIDING ACUTE CARE THROUGH A NETWORK OF HOSPITALS SUMMARIZED ON LINE 4A, THE PEACEHEALTH HEALTH CARE SYSTEM ALSO INCLUDES CLINICS AND MEDICAL GROUPS LOCATED IN ALASKA, WASHINGTON AND OREGON. 3140510994 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 1 1 1 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 1047 0 1 20848 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 11 11 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AK OR WA X JEFF SEIRER 3607291000 1115 SE 164TH AVENUE VANCOUVER WA 98683 KARL CARRIER BOD CHAIR 2.00 3.00 X X 0 0 0 ANDREA NENZEL CSJP VICE CHAIR 2.00 2.00 X X 0 0 0 CAROL AARON DIRECTOR/VICE CHAIR 2.00 2.00 X X 0 0 0 LEE KEARNEY TREASURER THRU 9/22 2.00 2.00 X X 0 0 0 KEVIN MURPHY DIRECTOR 2.00 2.00 X 0 0 0 KATHLEEN PRUITT CSJP DIRECTOR 2.00 2.00 X 0 0 0 CHARLOTTE DAVENPORT CSJP PART-YR SEC/DIR THRU 1/23 0.50 0.50 X X 0 0 0 TODD STRUMWASSER MD DIRECTOR 2.00 2.00 X 0 0 0 RICK WOLLENBERG DIRECTOR 2.00 2.00 X 0 0 0 TIM ACKMAN DIRECTOR 2.00 2.00 X 0 0 0 DAN HOLLINGSHEAD DIRECTOR 2.00 2.00 X 0 0 0 DONNA KING DIRECTOR 2.00 2.00 X 0 0 0 MARY O MCWILLIAMS DIRECTOR THRU 06/5/23 1.00 1.00 X 0 0 0 ELIZABETH V DUNNE PRESIDENT & CEO 40.00 2.00 X 3554035 0 57901 CRAIG ARMSTRONG ASS GEN COUNSEL/ASST SEC 40.00 2.00 X 277871 0 19110 RON L SAXTON EVP GEN CSL/PART-YR SECRETARY 40.00 2.00 X 1213206 0 73127 THOMAS KARNES SVP GEN CSL/PART-YRR SEC 40.00 2.00 X 250925 0 34556 DARRIN MONTALVO EVP CHF FIN-GROWTH OFF/PART-YR TREAS 40.00 2.00 X 1531560 0 223292 RICHARD DECARLO CHIEF OPERATING OFFICER/EVP 40.00 2.00 X 1668539 0 136876 MICHAEL P DWYER EVP STRATEGY/COMMUNITY HEALTH 40.00 2.00 X 1042336 0 76376 STEVEN GLENN EVP CHIEF BUS. AND TECH OFFICER 40.00 2.00 X 1176190 0 121309 WILLIAM R WEIDER SVP CIO 40.00 2.00 X 573184 0 136233 SARAH NESS EVP CAO 40.00 2.00 X 799912 0 114850 KIM SULLIVAN SVP CHIEF REVENUE OFFICER 40.00 2.00 X 178889 0 1073 MICHELLE A JAMES SVP PATIENT CARE SVCS AND CNO 40.00 2.00 X 225484 0 7612 EVE LOGSDON SVP CHIEF HR OFFICER 40.00 2.00 X 192942 0 5234 SEAN GREGORY MD CHIEF EXECUTIVE COLUMBIA 40.00 2.00 X 1044183 0 98179 TODD SALNAS CHIEF EXECUTIVE OREGON 40.00 2.00 X 989192 0 195155 CHARLES PROSPER CHIEF EXECUTIVE NORTHWEST 40.00 2.00 X 1036788 0 179149 MICHAEL C METCALF CHIEF EXECUTIVE PHMG 40.00 2.00 X 1020200 0 6164 DOUGLAS KOEKKOEK CHIEF PHYS AND CLINICAL EXECUTIVE 40.00 2.00 X 1073188 0 125793 WEN-HUAN S HO MD MD GASTROENTEROLOGY 40.00 2.00 X 1217697 0 84781 DAVID SAENGER MD MD CARDIOLOGY 40.00 2.00 X 1161689 0 96461 KARMAN TANDOM MD CARDIOLOGY 40.00 2.00 X 1087892 0 63963 MANJUNATH G RAJU MD CARDIOLOGY 40.00 2.00 X 1212488 0 91266 MARK EICHLER MD GENERAL SURGERY 40.00 2.00 X 1131756 0 90724 JOLINE M TREANOR FORMER EVP PEOPLE AND CULTURE 0.00 0.00 X 1355362 0 -1266 MARK B HALLETT FORMER SVP CMO 0.00 0.00 X 545779 0 0 JOHN C BENNETT FORMER CHIEF EXECUTIVE AMBULATORY 0.00 0.00 X 216348 0 0 MARY E KINGSTON FORMER CHIEF EXECUTIVE OREGON 0.00 0.00 X 492508 0 0 26270143 0 2037918 3809 1 1 0 AYA HEALTHCARE INC 5930 CORNERSTONE CT W SUITE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING 90486046 NURSEFINDERS LLC 524 E LAMAR BLVD SUITE 300 ARLINGTON TX 76011 HEALTHCARE STAFFING 38611309 QUEST DIAGNOSTICS 1737 AIRPORT WAY SUITE 200 SEATTLE WA 98134 LABORATORY SERVICES 37859997 TRIMEDX HOLDINGS LLC 5451 LAKEVIEW PKWY S DRIVE INDIANAPOLIS IN 46268 CLINICAL ENGINEERING 27576584 EXPRESS SERVICES INC 8516 NW EXPRESSWAY OKLAHOMA CITY OK 73162 HEALTHCARE STAFFING 16172487 397 19143969 6129915 12066380 37340264 PATIENT SERVICE REV 621110 3206961295 3206961295 OTHER OPERATING REV 621110 54229369 54229369 3261190664 36912214 36912214 10987889 2366878 8621011 8621011 8621011 3908162682 257792 3912348257 446337 -4185575 -188545 -4374120 -4374120 CAFETERIA 722514 5008219 5008219 5008219 3344698252 3261190664 0 46167324 4667050 4667050 107858 107858 19385722 17126060 2259662 1752623550 1547659826 204202726 760998 97763463 86333832 11391136 38495 122606044 108207374 14277195 121475 117260067 103547066 13662300 50701 4631721 4091833 539888 3281053 2898603 382450 578951 511467 67484 373000 329522 43478 546006 482362 63644 341838460 301799308 39820276 218876 2536398 2235182 294916 6300 8608635 7489131 988138 131366 47123522 41622910 5491847 8765 87337680 77157319 10180361 12131516 10703669 1412273 15574 8399 7420 979 51528340 45522031 6006309 136161925 120289248 15871312 1365 33757913 29822982 3934931 MED SUPPLIES AND SVCS 568710983 502420204 66290779 OTHER TAX 108778071 96098550 12679521 ALL OTHER EXPENSES 33264896 29380187 3876505 8204 3555611223 3140510994 413738110 1362119 10437262 59152321 642134840 654410929 474195437 489048154 138364695 188360695 101522501 89707141 36795835 42603731 3400112057 2114464807 1194333561 1285647250 1480082687 1284295591 140483890 239125542 44678812 41460867 357893015 309219909 4620922535 4683032130 587085161 491768741 1992508 3250740 1415457773 1408139356 307934964 517393203 2312470406 2420552040 X 2308452129 2262480090 2308452129 2262480090 4620922535 4683032130 X -210912971 108356096 56584836 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 1168844 0 0 1168844 0 PART II-B, LINE 1B PEACEHEALTH ENGAGES IN LOBBYING ACTIVITIES THROUGH EMPLOYEES DIRECTLY CONTACTING LEGISLATORS, THEIR STAFFS, OR GOVERNMENT OFFICIALS TO ADVOCATE IN SUPPORT OF OR OPPOSITION TO PENDING MEASURES THAT IMPACT PEACEHEALTH HEALTHCARE OPERATIONS AND THE HEALTH AND WELL-BEING OF THE COMMUNITIES PEACEHEALTH SERVES. PART II-B, LINE 1G PEACEHEALTH ENGAGES IN LOBBYING ACTIVITIES THROUGH EMPLOYEES, PAID OUTSIDE CONSULTING FIRMS, AND MEMBERSHIP DUES PAID TO STATE AND NATIONAL ASSOCIATIONS. THESE INDIVIDUALS AND ENTITIES DIRECTLY CONTACT LEGISLATORS, THEIR STAFFS, OR GOVERNMENT OFFICIALS TO ADVOCATE IN SUPPORT OF OR OPPOSITION TO PENDING MEASURES THAT IMPACT PEACEHEALTH HEALTHCARE OPERATIONS AND THE HEALTH AND WELL-BEING OF THE COMMUNITIES PEACEHEALTH SERVES. 55504288 1721108 545347 1495502 56275241 52125596 10331158 -3897780 3054686 55504288 41480654 579275 10381977 316310 52125596 41337915 923802 -17819 773244 41470654 40596095 1162077 1202504 1622761 41337915 0.16539 0.61671 0.21791 0 1 1 91286966 91286966 1479071946 944811965 534259981 142807065 71754632 71052433 1464634169 1094814895 369819274 222311911 3083315 219228596 1285647250 LIMITED PARTNERSHIPS 239125542 F 239125542 PENDING TRADES RECEIVABLE 33482847 INTEREST IN RELATED FOUNDATIONS 193360534 RIGHT OF USE ASSETS 82376528 309219909 OBLIGATIONS UNDER LEASES 82515312 INTEREST RATE SWAPS 54425723 ACCRUED PENSION LIABILITY 93123078 SELF-INSURANCE LIABILITY 20366762 LOC PAYABLE 243476615 CONDITIONAL ARO LIABILITY 22065677 OTHER LIABILITIES 1420036 517393203 X PART V, LINE 4: THE REPORTED ENDOWMENT FUNDS BELONG TO THE PEACEHEALTH FOUNDATIONS. THE PEACEHEALTH FOUNDATIONS ARE SEPARATELY INCORPORATED AND EACH FOUNDATION FILES A SEPARATE FORM 990. REFER TO THE SCHEDULE R, PART II FOR A LISTING OF THESE RELATED FOUNDATIONS. THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE FOR: 1) THE PURCHASE OF PROPERTY, PLANT, AND EQUIPMENT 2) SUPPORT FOR HOSPICE AND INDIGENT CARE 3) PATIENT CARE AND OTHER OPERATING ACTIVITIES PART X, LINE 2: PEACEHEALTH AND PEACEHEALTH NETWORKS HAVE RECEIVED DETERMINATION LETTERS FROM THE INTERNAL REVENUE SERVICE STATING THAT THEY ARE EXEMPT FROM FEDERAL AND STATE INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME. IT IS MANAGEMENT'S BELIEF THAT NONE OF ITS ACTIVITIES HAVE PRODUCED MATERIAL UNRELATED BUSINESS INCOME. THE CORPORATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT EXCEEDS A 50% PROBABILITY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN ESTIMATE OCCURS. CERTAIN AFFILIATED ENTITIES INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS MAY BE SUBJECT TO TAXATION. THE TAX EXPENSE AND RELATED PROVISION FOR THESE ENTITIES ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. PART X, LINE 2 THE CORPORATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT EXCEEDS A 50 PERCENT PROBABILITY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN ESTIMATE OCCURS. 0 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 1 0 GRANTMAKING 107858 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICE SELF-INSURANCE 28861439 1 0 0 0 1 0 28969297 0 28969297 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, PROGRAM SERVICES 107858 BANK WIRE 0 1 0 0 0 0 0 0 0 PART I, LINE 2: PEACEHEALTH SUPPORTS A MEDICAL MISSION PROGRAM IN EL SALVADOR. THIS MISSION USES MEDICAL PROFESSIONALS TO RENDER HEALTHCARE ASSISTANCE TO PEOPLE WITH LIMITED FINANCIAL RESOURCES. THESE ACTIVITIES ARE IN THE PEACEHEALTH BUDGET AND ARE INCLUDED IN THE OPERATING RESULTS OF PEACEHEALTH THE SAME AS OTHER PEACEHEALTH OPERATIONS. THE MISSION PROGRAM IS SUBJECT TO THE SAME MANAGEMENT CONTROL AND OVERSIGHT AS THE ORGANIZATION'S DOMESTIC PROGRAMS. PART III ACCOUNTING METHOD: 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 54021441 54021441 0.01520 749862847 509890360 239972487 0.06750 803884288 509890360 293993928 0.08270 7306278 7306278 0.00210 12386400 1335507 11050893 0.00310 7174750 4277961 2896789 0.00080 4134645 4134645 0.00120 31002073 5613468 25388605 0.00720 834886361 515503828 319382533 0.08990 19107 19107 0.00000 29836 29836 0.00000 9825 9825 0.00000 3415 3415 0.00000 62183 62183 0.00000 0 10644701 21408652 609235703 635489559 -26253856 X 1 1 10 1 PH SACRED HEART MED CTR AT RIVERBEND 3333 RIVERBEND DRIVE SPRINGFIELD OR 97477 X X X 2 PH SACRED HEART MED CTR UNIV DISTRICT 1255 HILYARD STREET EUGENE OR 97401 X X X 3 PH SOUTHWEST MEDICAL CENTER 400 NE MOTHER JOSEPH PL VANCOUVER WA 98683 X X X 4 PH ST JOSEPH MEDICAL CENTER 2901 SQUALICUM PARKWAY BELLINGHAM WA 98225 X X X 5 PH ST JOHN MEDICAL CENTER 1615 DELAWARE STREET LONGVIEW WA 98632 X X X 6 PH KETCHIKAN MEDICAL CENTER 3100 TONGASS AVENUE KETCHIKAN AK 99901 X X X X 7 PH PEACE HARBOR MEDICAL CENTER 400 9TH STREET FLORENCE OR 97439 X X X 8 PH COTTAGE GROVE COMMUNITY MED CTR 1515 VILLAGE DRIVE COTTAGE GROVE OR 97424 X X X 9 PH PEACE ISLAND MEDICAL CENTER 1117 SPRING STREET FRIDAY HARBOR WA 97401 X X X 10 PH UNITED GENERAL MEDICAL CENTER 4000 HOSPITAL DRIVE SEDROWOOLLEY WA 98284 X X X FACILITY REPORTING GROUP A 0 0 1 X X X X X X X X X 22 1 1 1 1 X PEACEHEALTH.ORG/ABOUT-PEACEHEALTH/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X X 1 22 1 SEE PART V 0 1 X 300.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.PEACEHEALTH.ORG/PATIENT-FINANCIAL-ASSISTANCE X WWW.PEACEHEALTH.ORG/FINANCIAL-ASSISTANCE-APPLICATION X WWW.PEACEHEALTH.ORG/PLAIN-LANGUAGE-SUMMARY X X X X X X 1 X 0 X X X 1 X 0 0 FACILITY REPORTING GROUP A PART V, SECTION B, LINE 5: TO OBTAIN CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE PEACEHEALTH MEDICAL CENTERS, THE COMMUNITY HEALTH NEEDS ASSESSMENTS TOOK INTO ACCOUNT INFORMATION FROM: 1) PERSONS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. 2) FEDERAL, TRIBAL, REGIONAL, STATE, AND LOCAL HEALTH DEPARTMENTS AND AGENCIES. 3) LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. 4) REVIEW OF AVAILABLE PUBLISHED COMMUNITY HEALTH DATA. 5) MEETINGS WITH COMMUNITY GROUPS AND PUBLIC OFFICIALS; PUBLIC FORUMS, FOCUS GROUPS AND COMMUNITYWIDE HEALTH ASSET SURVEY AND KEY INFORMANT INTERVIEWS.PLEASE REFER TO THE PUBLISHED CHNAS FOR FURTHER DETAILS. THESE REPORTS CAN BE FOUND AT: WWW.PEACEHEALTH.ORG/ABOUT-PEACEHEALTH/COMMUNITY-HEALTH/NEEDS-ASSESSMENT FACILITY REPORTING GROUP A PART V, SECTION B, LINE 6A: PEACEHEALTH HOSPITALS WORK IN CONCERT TO CONDUCT CHNAS IF THEY SERVE THE SAME COMMUNITY OR AN OVERLAPPING COMMUNITY. PEACEHEALTH HOSPITALS WITHIN A NETWORK (GEOGRAPHIC REGION) ALSO WILL WORK TOGETHER EVEN WHEN THE COMMUNITIES ARE NOT OVERLAPPING.ALL HOSPITALS CONDUCTED INDEPENDENT CHNA'S FOR THE 2022-2025 CYCLE. ALTHOUGH INDEPENDENT, THE OVERALL PEACEHEALTH SYSTEM SHARED ASSESSMENT OUTCOMES FROM ALL LOCATIONS. THE FOLLOWING HOSPITALS CONDUCTED CHNA'S: SACRED HEART MEDICAL CENTER AT RIVERBEND; SACRED HEART MEDICAL CENTER UNIVERSITY DISTRICT; PEACEHEALTH SOUTHWEST MEDICAL CENTER; ST. JOSEPH MEDICAL CENTER; ST. JOHN MEDICAL CENTER; KETCHIKAN MEDICAL CENTER; PEACE HARBOR MEDICAL CENTER; COTTAGE GROVE COMMUNITY MEDICAL CENTER; PEACE ISLAND MEDICAL CENTER; UNITED GENERAL MEDICAL CENTER. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 6B: REFER TO THE PUBLISHED CHNAS AT: WWW.PEACEHEALTH.ORG/ABOUT-PEACEHEALTH/COMMUNITY-HEALTH/NEEDS-ASSESSMENTFOR DETAILS ABOUT WHAT ORGANIZATIONS PARTICIPATED IN THE CHNAS. THE PEACEHEALTH HOSPITALS' CHNAS WERE UNDERTAKEN CONCURRENT WITH THE PLANNING ACTIVITIES OF COMMUNITY HEALTH ORGANIZATIONS IN THE STATE, REGION AND COUNTY. THE FOLLOWING HOSPITAL FACILITIES AND ORGANIZATIONS COLLABORATED IN THE COMPLETION OF THE CHNAS:SACRED HEART MEDICAL CENTER RIVERBEND, SACRED HEART MEDICAL CENTER UNIVERSITY DISTRICT, COTTAGE GROVE COMMUNITY MEDICAL CENTER AND PEACE HARBOR MEDICAL CENTER COLLABORATED WITH THE OREGON STATE HEALTH IMPROVEMENT PLAN, LIVE HEALTHY LANE (LHL), UNITED WAY OF LANE COUNTY, SIUSLAW VISION, AND BE YOUR BEST.ST. JOSEPH MEDICAL CENTER, PEACE ISLAND MEDICAL CENTER, AND UNITED GENERAL MEDICAL CENTER COLLABORATED WITH THE WASHINGTON STATE HEALTH IMPROVEMENT PLAN, SAN JUAN COUNTY COMMUNITY HEALTH INITIATIVES CONSORTIUM (CHIC), SAN JUAN ISLAND COMMUNITY FOUNDATION'S COMMUNITY NEEDS TASKFORCE, WHATCOM COUNTY HEALTH DEPARTMENT, HEALTHY WHATCOM TEAM, SKAGIT COUNTY POPULATION HEALTH TRUST, AND THE NORTH SOUND ACCOUNTABLE COMMUNITY OF HEALTH (NS-ACH). THE NS-ACH INCLUDES REPRESENTATIVES FROM THE FIVE-COUNTY AREA THAT INCLUDES SAN JUAN ISLAND, SKAGIT, SNOHOMISH AND WHATCOM COUNTIES.KETCHIKAN MEDICAL CENTER COLLABORATED WITH THE STATE OF ALASKA, THE KETCHIKAN WELLNESS COALITION, ALASKA NATIVE TRIBAL HEALTH CONSORTIUM, AND KETCHIKAN INDIAN COMMUNITY. SOUTHWEST MEDICAL CENTER COLLABORATED WITH THE WASHINGTON STATE HEALTH IMPROVEMENT PLAN, CLARK COUNTY PUBLIC HEALTH DEPARTMENT, THE HEALTHY LIVING COLLABORATIVE OF SOUTHWEST WASHINGTON, AND SOUTHWEST WASHINGTON ACCOUNTABLE COMMUNITY OF HEALTH (SWACH).ST. JOHN MEDICAL CENTER COLLABORATED WITH THE WASHINGTON STATE HEALTH IMPROVEMENT PLAN, COWLITZ COUNTY PUBLIC HEALTH DEPARTMENT, CASCADE PACIFIC ACTION ALLIANCE; THE HEALTHY LIVING COLLABORATIVE OF SOUTHWEST WASHINGTON, AND PATHWAYS 2020. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 7D: ALL CHNA'S AND CHNA REPORTS ARE AVAILABLE UPON REQUEST AND AT WWW.PEACEHEALTH.ORG/ABOUT-PEACEHEALTH/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENTTHE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE ON THE PEACEHEALTH WEBSITE.FACILITY REPORTING GROUP A:PART V, SECTION B, LINE 9: ALL PEACEHEALTH HOSPITALS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FROM APRIL THROUGH JUNE 2020. THESE ASSESSMENTS ARE CONDUCTED EVERY THREE YEARS. PEACEHEALTH COMPLETED THE 2022-2025 CHNA CYCLE IN THE FALL OF 2022. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 11: PLEASE REFER TO THE PUBLISHED CHNAS LOCATED AT:WWW.PEACEHEALTH.ORG/ABOUT-PEACEHEALTH/COMMUNITY-HEALTH/NEEDS-ASSESSMENTTHE PUBLISHED CHNAS CONTAIN THE IMPLEMENTATION PLAN(S) COVERING HOW THE PEACEHEALTH MEDICAL CENTERS ARE ADDRESSING THE SIGNIFICANT NEEDS OF THEIR RESPECTIVE COMMUNITIES. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 13H: PEACEHEALTH USES THE FEDERAL POVERTY GUIDELINES (FPL) AND CRITERIA THAT ASSESS AN INDIVIDUAL'S ABILITY TO PAY FOR DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE THAT WILL BE PROVIDED. EACH INDIVIDUAL SITUATION IS REVIEWED INDEPENDENTLY WITH ALLOWANCES MADE FOR EXTENUATING CIRCUMSTANCES.FOR ADDITIONAL DESCRIPTION, REFER TO SCHEDULE H, PART VI EXPLANATION FOR PART I, LINE 3C.FACILITY REPORTING GROUP A:PART V, SECTION B, LINE 22D: IRS REQUIREMENTS FOR CHARITABLE HOSPITALS 501(R) LIMITATION ON CHARGES AN ELIGIBLE INDIVIDUAL RECEIVING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE UNDER A PEACEHEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERAGE. TO DETERMINE AMOUNTS GENERALLY BILLED (AGB), THE "LOOK BACK" METHOD IS APPLIED FOR MEDICARE FEE-FOR-SERVICE AND PRIVATE INSURER ACCOUNTS.PEACEHEATH HAS A FAP THAT PROVIDES FOR DISCOUNTS TO ELIGIBLE INDIVIDUALS ON A SLIDING SCALE UP TO 400% OF THE FEDERAL POVERTY LEVEL. WHILE THE RATE INSURED INDIVIDUALS ARE ULTIMATELY CHARGED VARIES WITH CONTRACT AND BENEFIT TERMS, WE BELIEVE THAT OUR FAP DISCOUNTS PROVIDE ELIGIBLE INDIVIDUALS WITH BETTER OR SIMILAR DISCOUNTS. OUR MINIMUM UNINSURED FAP REDUCTION IS 70% WITH A MAXIMUM UNINSURED DISCOUNT OF 100%. FOR INSURED ACCOUNTS WE OFFER DISCOUNTS RANGING FROM 70% TO 100% DEPENDING ON FEDERAL POVERTY GUIDELINES. WE DO NOT USE GROSS CHARGES WITHOUT DISCOUNTS FOR INDIVIDUALS ELIGIBLE UNDER OUR FAP. PART V, SECTION B, LINES 7A AND 10A THE CHNA CAN BE VIEWED AT:WWW.PEACEHEALTH.ORG/ABOUT-PEACEHEALTH/PAGES/COMMUNITY-HEALTH-NEEDS-ASSESSMENTTHE MOST RECENTLY ADOPTED IMPLEMENTATION STRTEGY IS AVAILABLE ON THE PEACEHEALTH WEBSITE. PART I, LINE 3C: PEACEHEALTH USES THE FEDERAL POVERTY GUIDELINES (FPL) AS WELL AS THE FOLLOWING CRITERIA FOR DETERMINING THE AMOUNT OF FINANCIAL ASSISTANCE THAT WILL BE PROVIDED. CONSIDERATION FOR FINANCIAL ASSISTANCE INCLUDES A REVIEW OF:* GROSS HOUSEHOLD INCOME* NUMBER OF PEOPLE IN THE HOME PART I, LINE 7: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I LINE 7 IS AS FOLLOWS:COST TO CHARGE RATIOS WERE CALCULATED BY TOTAL BUSINESS UNIT OPERATING EXPENSE DIVIDED BY TOTAL GROSS PATIENT REVENUE. THIS RATIO WAS THEN APPLIED TO THE PATIENT CHARGES BY FINANCIAL CLASS IN THE BUSINESS UNIT TO ESTIMATE COST BY FINANCIAL CLASS. THE COST BY FINANCIAL CLASS WAS THEN OFFSET BY REVENUE, INCLUDING ALLOCATIONS OF REVENUE OUTSIDE OF THE BILLING SYSTEM. THE REVENUE OUTSIDE OF THE BILLING SYSTEM CONSISTS OF PROVIDER TAXES, 3RD PARTY SETTLEMENTS, AND OTHER OFFSETTING REVENUE RECORDED IN THE GENERAL LEDGER. FOR CHARITY CARE, THE COST TO CHARGE RATIO WAS APPLIED TO ALL CHARITY CARE DEDUCTIONS.PART I, LINE 7THE REPORTED COMMUNITY BENEFIT AMOUNTS DO NOT CAPTURE CERTAIN ADDITIONAL COMMUNITY BENEFIT ACTIVITIES AND CONTRIBUTIONS MADE DIRECTLY BY THE PEACEHEALTH AFFILIATED, SEPARATELY INCORPORATED FOUNDATIONS. PROCESSES ARE STILL UNDERWAY TO ALIGN AND COORDINATE ALL COMMUNITY BENEFIT TRACKING. PART II, COMMUNITY BUILDING ACTIVITIES: PEACEHEALTH'S COMMUNITY BUILDING ACTIVITIES ARE AIMED AT THE CAUSES OF HEALTH PROBLEMS, FREQUENTLY REFERRED TO AS SOCIAL DETERMINANTS OF HEALTH IN A LOCAL COMMUNITY, SUCH AS POVERTY, HOMELESSNESS, AND CARE ACCESS. THESE ACTIVITIES PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY'S RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE PEACEHEALTH MEDICAL CENTERS. PART III, LINE 2: REFER TO PART III, LINE 4 EXPLANATION FOR A DESCRIPTION OF THE METHODOLOGY FOR COMPUTING BAD DEBTS.THE AMOUNTS REPORTED REPRESENT THE PATIENT ACCOUNT BALANCES WRITTEN OFF TO BAD DEBT DURING THE YEAR ALONG WITH THE CHANGE IN THE ESTIMATE IN THE BAD DEBT RESERVES ON OUTSTANDING PATIENT ACCOUNTS RECEIVABLE BALANCES LESS ANY RECOVERIES ON PATIENT ACCOUNTS. PART III, LINE 3: THE METHODOLOGY USED TO DETERMINE THE AMOUNT ON PART III, LINE 3 IS AS FOLLOWS:DEMOGRAPHIC DATA REGARDING POPULATION POVERTY LEVELS IN EACH FACILITY'S SERVICE AREA WERE USED TO DETERMINE THE AMOUNT OF BAD DEBT REASONABLY ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY.PART III, LINE 4: 6/30/2023 AUDITED FINANCIAL STATEMENTS - FOOTNOTE (3) REVENUE RECOGNITION (A) NET PATIENT SERVICE REVENUE:PATIENT SERVICE REVENUE RELATES TO CONTRACTS WITH PATIENTS INVOLVING THIRD-PARTY PAYORS WHERE THE CORPORATION HAS AN OBLIGATION TO PERFORM HEALTHCARE SERVICES. THIS REVENUE IS RECORDED AT THE AMOUNT DUE FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS WHEN THE PERFORMANCE OBLIGATIONS ARE SATISFIED. THE CORPORATION BASES THE IMPLICIT PRICE CONCESSIONS ON HISTORICAL COLLECTIBILITY DATA BY PAYOR USING A PORTFOLIO APPROACH TO RECOGNIZE THE DEDUCTIONS NETTED AGAINST REVENUE WHEN IT IS RECOGNIZED. PART III, LINE 8: THE CALCULATION FOR PART III, LINE 8 IS COMPLETED USING MEDICARE COST REPORT DATA.THE MEDICARE AMOUNTS LISTED IN PART III, SECTION B ON LINES 5, 6, AND 7 ARE REPORTED FROM THE MEDICARE COST REPORTS AND DO NOT REPRESENT ALL OF THE REVENUES AND COSTS ASSOCIATED WITH PARTICIPATION IN MEDICARE PROGRAMS BY PEACEHEALTH. PART III SECTION B DOES NOT ALLOW FOR A FULL REPORTING OF MEDICARE REVENUES AND COSTS AS THE INSTRUCTIONS TO THE FORM 990 LIMIT MEDICARE REVENUES AND ALLOWABLE COSTS TO THOSE FROM THE MEDICARE COST REPORT. REVENUE AND COSTS FROM MEDICARE PART C PATIENTS, PART B PHYSICIAN SERVICES BILLED BY THE ORGANIZATION, AND CLINICAL LABORATORY SERVICES WERE NOT INCLUDED IN THE MEDICARE COST REPORT. IN ADDITION, HOSPITALS INCUR OTHER COSTS TO PROVIDE CARE THAT MEDICARE DOES NOT ALLOW IN THE COST REPORT.THE TOTAL REVENUES AND COSTS ATTRIBUTABLE TO ALL MEDICARE SERVICES ARE $609,235,703 AND $635,489,559 RESPECTIVELY. THIS RESULTS IN A TOTAL MEDICARE SHORTFALL OF $26,253,856. PART III, LINE 9B: FINANCIAL ASSISTANCE PROGRAM INFORMATION IS PRESENT ON PEACEHEALTH STATEMENTS AND BILLINGS. ACCOUNTS ARE NOT ASSIGNED TO COLLECTION AGENCIES PRIOR TO 120 DAYS FROM THE DATE OF FIRST BILLING. FINANCIAL ASSISTANCE APPLICATIONS FOR ACCOUNTS THAT HAVE BEEN ASSIGNED TO A COLLECTION AGENCY MUST BE SUBMITTED WITH PROOF OF INCOME FOR THE DATE(S) OF SERVICE, IF A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED FOR AN ACCOUNT PREVIOUSLY ASSIGNED TO COLLECTION, THE COLLECTION AGENCY IS REQUESTED TO HOLD FURTHER ACTIONS UNTIL THE RESULTS OF THE PENDING FINANCIAL ASSISTANCE REVIEW ARE AVAILABLE. IF THE REVIEW SHOWS THE PATIENT QUALIFIES FOR THE REDUCTION OR ELIMINATION OF THE DEBT, APPROPRIATE ACTIONS ARE TAKEN TO AMEND OR CORRECT PREVIOUS ACTIONS.THE COLLECTION POLICIES INVOLVE THE ISSUANCE OF A BILL ON OR SHORTLY AFTER DISCHARGE OR DEATH OF THE BENEFICIARY TO THE PARTY RESPONSIBLE FOR THE PATIENTS PERSONAL FINANCIAL OBLIGATIONS. THESE POLICIES ALSO INCLUDE OTHER ACTIONS SUCH AS SUBSEQUENT BILLINGS, COLLECTION LETTERS AND TELEPHONE CALLS OR PERSONAL CONTACTS WITH THIS PARTY WHICH CONSTITUTE A GENUINE, RATHER THAN A TOKEN, COLLECTION EFFORT.REFER TO THE SCHEDULE H, PART V SECTION ON BILLING AND COLLECTIONS. PART VI, LINE 2: THE COMMUNITY HEALTH NEEDS ASSESSMENT IS CUSTOMIZED TO THE LOCAL COMMUNITY. EACH PEACEHEALTH HOSPITAL CONDUCTS ITS OWN COMMUNITY HEALTH NEEDS ASSESSMENT.PEACEHEALTH PARTNERS WITH A DIVERSE GROUP OF COMMUNITY ORGANIZATIONS, INCLUDING MEDICAL PROFESSIONALS, OTHER NOT-FOR-PROFIT ORGANIZATIONS, AND STATE AND LOCAL GOVERNMENT AGENCIES TO IDENTIFY AND ASSESS THE SPECIFIC NEEDS OF THE COMMUNITIES IN WHICH IT SERVES.IN ORDER TO DETERMINE AND ACT ON THE HEALTH CARE NEEDS OF THE COMMUNITY PEACEHEALTH HAS ESTABLISHED A COMMITTEE OF STAFF, BOARD MEMBERS AND VOLUNTEERS TO REVIEW AND ACT ON FUNDING REQUESTS FROM COMMUNITY-BASED ORGANIZATIONS. IN MAKING THE CASE FOR FUNDING, APPLICANTS MUST THOROUGHLY EXPLAIN THE NEED, THE POPULATION SERVED, THE EFFECTIVENESS OF THEIR PROGRAMS AND THE DESIRED OUTCOME. IN ADDITION TO HELPING BOARD COMMITTEES MAKE WISE STRATEGIC INVESTMENT IN PROGRAMS THAT EFFECTIVELY ADDRESS COMMUNITY NEEDS, THIS PROCESS ALSO KEEPS STAFF AND BOARD MEMBERS ATTUNED TO CHANGES IN THE COMMUNITY.WHEN PEACEHEALTH EVALUATES A COMMUNITY'S NEED FOR A PARTICULAR SERVICE, A HOST OF FACTORS ARE ASSESSED, INCLUDING:-ALTERNATIVE WAYS TO ACCESS CARE-THE ABILITY TO PROVIDE THE NECESSARY STAFF, EQUIPMENT AND SPACE-THE EFFECT ON THE COMMUNITY AND PATIENTS IF PEACEHEALTH DID NOT PROVIDE THE SERVICE-THE COMMUNITY'S BEST INTEREST-THE RESULTS OF AN ETHICAL DISCERNMENT ON THE OVERALL IMPACT TO THE COMMUNITY-ADDITIONAL COMMUNITY RESOURCES OR FUNDS AVAILABLE TO SUPPORT COMMUNITY NEED-OVERALL IMPACT OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND BARRIERS TO CARE.ADDITIONAL WAYS PEACEHEALTH STAYS IN TOUCH WITH THE COMMUNITY:- PATIENT COUNCILS: COMMUNITY MEMBERS PROVIDE INPUT AND FEEDBACK ON THE PATIENT EXPERIENCE, ISSUES, CONCERNS AND IDEAS.-COMMUNITY INVOLVEMENT: HOSPITAL STAFF SERVE ON NUMEROUS BOARDS, COMMITTEES AND TASK FORCES THAT ADDRESS COMMUNITY HEALTH PROBLEMS AND PROMOTE COMMUNITY HEALTH.- SPEAKERS BUREAU: HOSPITAL LEADERS AND EXPERTS ARE CALLED UPON TO ADDRESS COMMUNITY GROUPS ON A VARIETY OF HEALTH CARE TOPICS TAKING FEEDBACK, ANSWERING QUESTIONS AND LISTENING TO CONCERNS AND NEEDS. -VOLUNTEERING: HOSPITAL STAFF PARTICIPATE IN SERVICE DAYS, GROUP ACTIVITIES AND ONE ON ONE ACTIVITIES TO DONATE TIME AND EXPERTISE TO LOCAL NONPROFITS ADDRESSING SOCIAL DETERMINANTS OF HEALTH. PART VI, LINE 3: PEACEHEALTH HAS A TIME-HONORED TRADITION OF PROVIDING HEALTH CARE SERVICES TO THE SICK AND AFFLICTED REGARDLESS OF ABILITY TO PAY. THIS CONCEPT IS CENTRAL TO OUR MISSION AND IS REINFORCED THROUGH OUR NEW EMPLOYEE ORIENTATION TRAINING AND DEVELOPMENT PROGRAMS, LEADERSHIP MEETINGS, AND SPECIAL PROGRAMS SUCH AS LEADERSHIP IN MINISTRY.PEACEHEALTH DELIVERS COST SAVINGS TO NEEDY PATIENTS VIA OUR FINANCIAL ASSISTANCE POLICY (FAP). THE FAP PROGRAM PROVIDES FREE OR REDUCED-COST CARE TO LOW-INCOME INDIVIDUALS. QUALIFIED INDIVIDUALS RECEIVE A LETTER WHICH THEY MAY PRESENT JUST AS ONE WOULD AN INSURANCE CARD. MANY INDEPENDENT PROVIDERS IN THE COMMUNITY NOW ACCEPT PEACEHEALTH'S FAP PROGRAM AS THEIR BENCHMARK FOR PROVIDING SERVICES AT REDUCED OR NO CHARGE. OUR FAP ASSISTANCE PROVIDES MEDICALLY NECESSARY AND SOME PREVENTATIVE SERVICES AT PEACEHEALTH FACILITIES AT A REDUCED COST OR WITHOUT CHARGE WHEN PAYMENT CANNOT BE OBTAINED THROUGH ALL OTHER AVAILABLE FINANCIAL RESOURCES. THE FAP PROGRAM IS SECONDARY TO ALL OTHER RESOURCES SUCH AS INSURANCE, THIRD PARTY LIABILITY PAYERS, GOVERNMENT PROGRAMS, OUTSIDE AGENCY PROGRAMS, OR PRIVATE MEANS. THE PURPOSE OF THE PROGRAM IS TO HELP MANAGE THE DELICATE BALANCE OF FINANCIAL HEALTH AND WISE STEWARDSHIP WITH OUR MISSION OF PROVIDING COMMUNITY SERVICES IN ALL OF OUR SERVICE AREAS. OUR FAP ENSURES THAT PATIENTS RECEIVE FAIR AND EQUAL FINANCIAL TREATMENT ACROSS PEACEHEALTH, AND IT WORKS TOGETHER WITH OUR FINANCIAL COUNSELING SERVICES TO HELP PEACEHEALTH IDENTIFY PATIENTS WHO CAN BENEFIT FROM FINANCIAL ASSISTANCE.HERE IS AN EXAMPLE OF HOW WE WORK WITH OUR LOCAL COMMUNITIES TO ENROLL PEOPLE IN THE PROGRAM: PEACEHEALTH SACRED HEART MEDICAL CENTER-UNIVERSITY DISTRICT WORKS CLOSELY WITH THE WHITEBIRD CLINIC THE AREA FEDERALLY QUALIFIED HEALTH CENTER (FQHC) TO ENSURE THAT ALL ELIGIBLE PATIENTS SEEKING MEDICAL CARE KNOW ABOUT THE PEACEHEALTH FINANCIAL ASSISTANCE PROGRAM. WHITEBIRD STAFF WORK WITH THE MEDICAL CENTER TO FOLLOW UP ON PATIENTS WHO FREQUENT THE EMERGENCY DEPARTMENT FOR CARE AND INFORM THEM OF AVAILABLE RESOURCES, INCLUDING POSSIBLE FINANCIAL ASSISTANCE. PATIENTS REFERRED FROM COMMUNITY HEALTH CENTERS SEEKING ACCESS TO DONATED SPECIALTY CARE ARE ROUTINELY ENROLLED IN FINANCIAL ASSISTANCE AS PART OF THE PROCESS FOR DETERMINING ELIGIBILITY FOR COMMUNITY-WIDE DONATED CARE. OUR UNIVERSITY DISTRICT HOSPITAL LOCATION IN PARTNERSHIP WITH WHITEBIRD IS PARTICULARLY POISED TO SERVE MINORITY POPULATIONS, THE UNDER-INSURED AND UN-INSURED AND THOSE NOT ACCESSING CARE.COMMUNICATION: ELIGIBLE PATIENTS ARE MADE AWARE OF THIS PROGRAM THROUGH A VARIETY OF COMMUNICATION CHANNELS INCLUDING:-REFERRALS FROM COMMUNITY PARTNERS, INCLUDING NONPROFIT COMMUNITY CLINICS THAT ARE FREE OR LOW-COST- INFORMATION POSTED ON OUR WEB SITE AT WWW.PEACEHEALTH.ORG-SIGNAGE IN OUR WAITING ROOMS*-BROCHURES THROUGHOUT OUR FACILITIES**-FINANCIAL COUNSELING.*AS PART OF OUR BASELINE OUTREACH PLAN, PEACEHEALTH POSTS SIGNS IN THE FOLLOWING AREAS:- REGISTRATION AREAS- RECEPTION AREA- PAY STATIONS**BROCHURES ARE MADE AVAILABLE IN THE FOLLOWING AREAS:-PHYSICIAN OFFICES-COUNTY HEALTH DEPARTMENTS-REGISTRATION BOOTH/DESK-CHECK-IN AREAS (LAB, IMAGING, ETC.)-WAITING AREAS-EXISTING BROCHURE DISPLAYS-ADMINISTRATION-PATIENT EXAM ROOMS (PROVIDER OFFICES)-PAY STATIONS PART VI, LINE 4: PEACEHEALTH OPERATES TEN HOSPITALS IN THREE STATES. IN ALASKA, PEACEHEALTH RUNS THE KETCHIKAN MEDICAL CENTER IN KETCHIKAN. IN OREGON, PEACEHEALTH OPERATES SACRED HEART MEDICAL CENTER UNIVERSITY DISTRICT (EUGENE), SACRED HEART MEDICAL CENTER AT RIVERBEND (SPRINGFIELD), PEACE HARBOR MEDICAL CENTER (FLORENCE), AND COTTAGE GROVE COMMUNITY MEDICAL CENTER (COTTAGE GROVE). IN WASHINGTON, PEACEHEALTH OPERATES SOUTHWEST WASHINGTON MEDICAL CENTER (VANCOUVER), PEACEHEALTH ST. JOHN MEDICAL CENTER (LONGVIEW), PEACEHEALTH ST. JOSEPH MEDICAL CENTER (BELLINGHAM), PEACEHEALTH UNITED GENERAL MEDICAL CENTER (SEDRO-WOOLLEY), AND PEACEHEALTH PEACE ISLAND MEDICAL CENTER (FRIDAY HARBOR).THE 2020 POPULATION OF ALASKA IS APPROXIMATELY 724,357, A 1.95% INCREASE COMPARED TO 2010. THE POPULATION OF KETCHIKAN GATEWAY-BOROUGH, AK IS APPROXIMATELY 13,991, AN INCREASE OF 3.08% COMPARED TO 2010. OF THE KETCHIKAN GATEWAY-BOROUGH POPULATION:- 63.9% ARE WHITE (60.2% STATEWIDE) 7% LIVE BELOW THE FEDERAL POVERTY LINE- 3.7% ARE BLACK (3.7% STATEWIDE) 34.6% LIVE BELOW THE FEDERAL POVERTY LINE- 15.6% ARE AMERICAN INDIANA/ALASKA NATIVE (15.6% STATEWIDE) 18.2% LIVE BELOW THE FEDERAL POVERTY LINE- 6.5% ARE ASIAN (6.5% STATEWIDE) 4.9% LIVE BELOW THE FEDERAL POVERTY LINE- 1.4% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (1.4% STATEWIDE) 50% LIVE BELOW THE FEDERAL POVERTY LINE- 7.3% ARE LATINX (7.3% STATEWIDE) 9.6% LIVE BELOW THE FEDERAL POVERTY LINE- 7.5% ARE MULTI-RACIAL (7.5% STATEWIDE) 15.3% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF ALASKA IS APPROXIMATELY 724,357, A 1.95% INCREASE COMPARED TO 2010. THE POPULATION OF PRINCE OF WALES-HYDER, AK IS APPROXIMATELY 5,889:- 44.9% ARE WHITE (60.2% STATEWIDE) 15.5% LIVE BELOW THE FEDERAL POVERTY LINE- 0.6% ARE BLACK (3.7% STATEWIDE) 10.3% LIVE BELOW THE FEDERAL POVERTY LINE- 42.6% ARE AMERICAN INDIANA/ALASKA NATIVE (15.6% STATEWIDE) 19.9% LIVE BELOW THE FEDERAL POVERTY LINE- 1.2% ARE ASIAN (6.5% STATEWIDE) 5.5% LIVE BELOW THE FEDERAL POVERTY LINE- 0.4% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (1.4% STATEWIDE) 70% LIVE BELOW THE FEDERAL POVERTY LINE- 3.9% ARE LATINX (7.3% STATEWIDE) 13.8% LIVE BELOW THE FEDERAL POVERTY LINE- 8.6% ARE MULTI-RACIAL (7.5% STATEWIDE) 16.2% LIVE BELOW THE FEDERAL POVERTY LINE- 1% ARE MULTI-RACIAL (5% COUNTYWIDE, 4% STATEWIDE) 14% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF LANE COUNTY, OR IS APPROXIMATELY 382,971, A 10.57% INCREASE COMPARED TO 2010. THE POPULATION OF EUGENE, OR IS APPROXIMATELY 176,654, AN INCREASE OF 12.98% COMPARED TO 2010. OF THE EUGENE POPULATION:- 78% ARE WHITE (81% COUNTYWIDE, 75% STATEWIDE) 18% LIVE BELOW THE FEDERAL POVERTY LINE- 2% ARE BLACK (1% COUNTYWIDE, 2% STATEWIDE) 28% LIVE BELOW THE FEDERAL POVERTY LINE- 1% ARE AMERICAN INDIANA/ALASKA NATIVE (2% COUNTYWIDE, 2% STATEWIDE) 36% LIVE BELOW THE FEDERAL POVERTY LINE- 5% ARE ASIAN (3% COUNTYWIDE, 5% STATEWIDE) 33% LIVE BELOW THE FEDERAL POVERTY LINE- 1% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (1% COUNTYWIDE, 1% STATEWIDE) 28% LIVE BELOW THE FEDERAL POVERTY LINE- 10% ARE LATINX (9% COUNTYWIDE, 13% STATEWIDE) 26% LIVE BELOW THE FEDERAL POVERTY LINE- 6% ARE MULTI-RACIAL (5% COUNTYWIDE, 4% STATEWIDE) 33% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF LANE COUNTY, OR IS APPROXIMATELY 382,971, A 10.57% INCREASE COMPARED TO 2010. THE POPULATION OF SPRINGFIELD, OR IS APPROXIMATELY 64,078, AN INCREASE OF 7.87% COMPARED TO 2010. OF THE SPRINGFIELD POPULATION:- 80% ARE WHITE (81% COUNTYWIDE, 75% STATEWIDE) 20% LIVE BELOW THE FEDERAL POVERTY LINE- 11% ARE BLACK (1% COUNTYWIDE, 2% STATEWIDE) 40% LIVE BELOW THE FEDERAL POVERTY LINE- 6% ARE AMERICAN INDIANA/ALASKA NATIVE (2% COUNTYWIDE, 2% STATEWIDE) 23% LIVE BELOW THE FEDERAL POVERTY LINE- 2% ARE ASIAN (3% COUNTYWIDE, 5% STATEWIDE) 10% LIVE BELOW THE FEDERAL POVERTY LINE- 2% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (1% COUNTYWIDE, 1% STATEWIDE) 78% LIVE BELOW THE FEDERAL POVERTY LINE- 1% ARE LATINX (9% COUNTYWIDE, 13% STATEWIDE) 20% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF LANE COUNTY, OR IS APPROXIMATELY 382,971, A 10.57% INCREASE COMPARED TO 2010. THE POPULATION OF FLORENCE, OR IS APPROXIMATELY 9,329, AN INCREASE OF 10.19% COMPARED TO 2010. OF THE FLORENCE POPULATION:- 90% ARE WHITE (81% COUNTYWIDE, 75% STATEWIDE) 14.7% LIVE BELOW THE FEDERAL POVERTY LINE- 0% ARE BLACK (1% COUNTYWIDE, 2% STATEWIDE) 100% LIVE BELOW THE FEDERAL POVERTY LINE- 1.4% ARE AMERICAN INDIANA/ALASKA NATIVE (2% COUNTYWIDE, 2% STATEWIDE) 25.4% LIVE BELOW THE FEDERAL POVERTY LINE- 1.8% ARE ASIAN (3% COUNTYWIDE, 5% STATEWIDE) 9.7% LIVE BELOW THE FEDERAL POVERTY LINE- 0.1% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (1% COUNTYWIDE, 1% STATEWIDE) 0% LIVE BELOW THE FEDERAL POVERTY LINE- 4.2% ARE LATINX (9% COUNTYWIDE, 13% STATEWIDE) 24.4% LIVE BELOW THE FEDERAL POVERTY LINE- 2.9% ARE MULTI-RACIAL (5% COUNTYWIDE, 4% STATEWIDE) 39.2% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF LANE COUNTY, OR IS APPROXIMATELY 382,971, A 10.57% INCREASE COMPARED TO 2010. THE POPULATION OF COTTAGE GROVE, OR IS APPROXIMATELY 10,657, AN INCREASE OF 10.02% COMPARED TO 2010. OF THE COTTAGE GROVE POPULATION:- 82% ARE WHITE (81% COUNTYWIDE, 75% STATEWIDE) 17.6% LIVE BELOW THE FEDERAL POVERTY LINE- 1.2% ARE BLACK (1% COUNTYWIDE, 2% STATEWIDE) 10.3% LIVE BELOW THE FEDERAL POVERTY LINE- 0.7% ARE AMERICAN INDIANA/ALASKA NATIVE (2% COUNTYWIDE, 2% STATEWIDE) 26.4% LIVE BELOW THE FEDERAL POVERTY LINE- 0.5% ARE ASIAN (3% COUNTYWIDE, 5% STATEWIDE) 0% LIVE BELOW THE FEDERAL POVERTY LINE- 0% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (1% COUNTYWIDE, 1% STATEWIDE) N/A- 9.6% ARE LATINX (9% COUNTYWIDE, 13% STATEWIDE) 36.8% LIVE BELOW THE FEDERAL POVERTY LINE- 6.8% ARE MULTI-RACIAL (5% COUNTYWIDE, 4% STATEWIDE) 36.3% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF CLARK COUNTY, WA IS APPROXIMATELY 501,869, A 17.62% INCREASE COMPARED TO 2010. THE POPULATION OF VANCOUVER, WA IS APPROXIMATELY 187,615, AN INCREASE OF 15.96% COMPARED TO 2010. OF THE VANCOUVER POPULATION:- 71.5% ARE WHITE (77.5% COUNTYWIDE, 67.5% STATEWIDE) 7.9% LIVE BELOW THE FEDERAL POVERTY LINE- 2.3% ARE BLACK (2.4% COUNTYWIDE, 4.4% STATEWIDE) 14.8% LIVE BELOW THE FEDERAL POVERTY LINE- 0.6% ARE AMERICAN INDIANA/ALASKA NATIVE (1.2% COUNTYWIDE, 1.9% STATEWIDE) 11.4% LIVE BELOW THE FEDERAL POVERTY LINE- 5.6% ARE ASIAN (5% COUNTYWIDE, 9.6% STATEWIDE) 11% LIVE BELOW THE FEDERAL POVERTY LINE- 1.5% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (0.9% COUNTYWIDE, 0.8% STATEWIDE) 19.9% LIVE BELOW THE FEDERAL POVERTY LINE- 13.9% ARE LATINX (10.2% COUNTYWIDE, 13% STATEWIDE) 16.1% LIVE BELOW THE FEDERAL POVERTY LINE- 6.0% ARE MULTI-RACIAL (4.3% COUNTYWIDE, 4.9% STATEWIDE) 12.5% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF COWLITZ COUNTY, WA IS APPROXIMATELY 114,275, A 11.64% INCREASE COMPARED TO 2010. THE POPULATION OF LONGVIEW, WA IS APPROXIMATELY 12,685, AN INCREASE OF 6.37% COMPARED TO 2010. OF THE LONGVIEW POPULATION:- 78.7% ARE WHITE (83.2% COUNTYWIDE, 67.5% STATEWIDE) 13% LIVE BELOW THE FEDERAL POVERTY LINE- 1.4% ARE BLACK (1.1% COUNTYWIDE, 4.4% STATEWIDE) 14% LIVE BELOW THE FEDERAL POVERTY LINE- 1.3% ARE AMERICAN INDIANA/ALASKA NATIVE (2.1% COUNTYWIDE, 1.9% STATEWIDE) 40.7% LIVE BELOW THE FEDERAL POVERTY LINE- 1.8% ARE ASIAN (1.6% COUNTYWIDE, 9.6% STATEWIDE) 4.2% LIVE BELOW THE FEDERAL POVERTY LINE- 0.1% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (0.4% COUNTYWIDE, 0.8% STATEWIDE) 0.5% LIVE BELOW THE FEDERAL POVERTY LINE- 11% ARE LATINX (9.3% COUNTYWIDE, 13% STATEWIDE) 25.8% LIVE BELOW THE FEDERAL POVERTY LINE- 8.1% ARE MULTI-RACIAL (3.7% COUNTYWIDE, 4.9% STATEWIDE) 16.4% LIVE BELOW THE FEDERAL POVERTY LINETHE 2020 POPULATION OF COWLITZ COUNTY, WA IS APPROXIMATELY 114,275, A 11.64% INCREASE COMPARED TO 2010. THE POPULATION OF KELSO, WA IS APPROXIMATELY 12,685, AN INCREASE OF 6.37% COMPARED TO 2010. OF THE KELSO POPULATION:- 75.4% ARE WHITE (83.2% COUNTYWIDE, 67.5% STATEWIDE) 13% LIVE BELOW THE FEDERAL POVERTY LINE- 1.3% ARE BLACK (1.1% COUNTYWIDE, 4.4% STATEWIDE) 14% LIVE BELOW THE FEDERAL POVERTY LINE- 4.1% ARE AMERICAN INDIANA/ALASKA NATIVE (2.1% COUNTYWIDE, 1.9% STATEWIDE) 40.7% LIVE BELOW THE FEDERAL POVERTY LINE- 1.4% ARE ASIAN (1.6% COUNTYWIDE, 9.6% STATEWIDE) 4.2% LIVE BELOW THE FEDERAL POVERTY LINE- 0% ARE NATIVE HAWAIIAN/PACIFIC ISLANDER (0.4% COUNTYWIDE, 0.8% STATEWIDE) 0.5% LIVE BELOW THE FEDERAL POVERTY LINE- 16.8% ARE LATINX (9.3% COUNTYWIDE, 13% STATEWIDE) 25.8% LIVE BELOW THE FEDERAL POVERTY LINE- 6.2% ARE MULTI-RACIAL (3.7% COUNTYWIDE, 4.9% STATEWIDE) 16.4% LIVE BELOW THE FEDERAL POVERTY LINE(SEE PART VI, LINE 4 CONTINUED) PART VI, LINE 5: PEACEHEALTH IS AN INTEGRATED, NOT-FOR-PROFIT HEALTH SYSTEM THAT OFFERS A FULL CONTINUUM OF HEALTH AND WELLNESS SERVICES IN THE NORTHWEST. PEACEHEALTH CONTRIBUTES TO THE HEALTH OF THE COMMUNITY BY OFFERING A VARIETY OF SERVICES TO ATTEND TO PREVENTATIVE, ACUTE AND CHRONIC HEALTH CARE SERVICES WITHIN THE COMMUNITIES IT SERVES, THE PEACEHEALTH MISSION IS TO CARRY ON THE HEALING MISSION OF JESUS CHRIST BY PROMOTING PERSONAL AND COMMUNITY HEALTH RELIEVING PAIN AND SUFFERING AND TREATING EACH PERSON IN A LOVING AND CARING WAY. OUR VISION IS TO ENSURE THAT EVERY PERSON RECEIVES SAFE, COMPASSIONATE CARE; EVERY TIME, EVERY TOUCH. PEACEHEALTH PROVIDES EXCEPTIONAL MEDICINE, AND ENDEAVORS TO ALWAYS SERVE THE MOST VULNERABLE AMONG US. PEACEHEALTH RECOGNIZES THE NEED FOR INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED TO ACCESS HEALTH CARE AND PEACEHEALTH PROVIDES THOSE SERVICES EQUALLY TO ALL BASED ON THEAFFORDABLE CARE ACTS CHNA GUIDELINES, EVERY 501(C)3 HOSPITAL MUST CONDUCT ITS OWN UNIQUE CHNA. A CHNA HAS BEEN COMPLETED FOR EACH PEACEHEALTH HOSPITAL.THE COMPLETED CHNAS ALLOW FOR DEEPER UNDERSTANDING OF THE HEALTH NEEDS OF OUR COMMUNITIES. OUR BROAD ANALYSIS OF SECONDARY DATA, COMMUNITY FEEDBACK, AND SYSTEMWIDE PEACEHEALTH INPUT REVEALED A REMARKABLE LEVEL OF COMMONALITY IN THE HEALTH CONCERNS OF OUR VARIOUS COMMUNITIES. EACH HOSPITAL HAS IDENTIFIED PLANS TO ADDRESS PRIORITIZED NEEDS AND CONTINUES TO PURSUE OPPORTUNITIES TO ENHANCE THE OVERALL WELLBEING OF THE COMMUNITY. THESE PLANS ARE OUTLINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLANS FOR EACH AREA, WERE RELEASED IN WINTER 2019 AND ARE AVAILABLE ONLINE AT HTTPS://WWW.PEACEHEALTH.ORG/COMMUNITY-HEALTH-IMPROVEMENT-PLANS AND WILL BE UPDATED ANNUALLY.PEACEHEALTH HAS THE WHEREWITHAL TO IMPROVE POPULATION HEALTH IN ALL REGIONS SERVED BY PEACEHEALTH MEDICAL FACILITIES. THROUGH SYSTEMWIDE SHARING OF BEST PRACTICES, PEACEHEALTH IS IMPROVING AND SUPPORTING THE POPULATION HEALTH OF OUR COMMUNITIES ACROSS THE NORTHWEST. PART VI, LINE 6: PEACEHEALTH IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES AK,OR,WA 0 YMCA 2055 PATTERSON ST EUGENE OR 97405 930500679 501(C)(3) 450000 0 MISSION SUPPORT SISTERS OF ST JOSEPH OF PEACE 1663 KILLAMEY WAY PO BOX 248 BELLEVUE WA 98009 910567741 501(C)(3) 403929 0 HOUSING ASSISTANCE MERCY HOUSING NW 6930 MARTIN LUTHER KING JR S SEATTLE WA 98118 911546525 501(C)(3) 300000 0 EDUCATION SUPPORT LANE COMMUNITY COLLEGE 4000 E 30TH AVE EUGENE OR 97405 930546223 GOVT 275000 0 COMMUNITY BENEFIT ST VINCENT DE PAUL PO BOX 24608 EUGENE OR 97402 930454786 501(C)(3) 274314 0 HOUSING ASSISTANCE HOUSING OPPORTUNITIES OF SW WASHINGTON 820 11TH AVE LONGVIEW WA 98632 911012000 GOVT 250000 0 HOUSING ASSISTANCE CITY OF KELSO HOUSING AUTHORITY 1415 S 10TH AVE KELSO WA 98626 916001995 GOVT 200000 0 COMMUNITY BENEFIT NORTHWEST REGIONAL COUNCIL 600 LAKEWAY DR BELLINGHAM WA 98225 911590083 GOVT 160014 0 COMMUNITY BENEFIT THE OREGON COMMUNITY 1221 SW YAMHILL ST SUITE 100 PORTLAND OR 97205 237315673 501(C)(3) 150000 0 COMMUNITY BENEFIT WHATCOM CLUBHOUSE 1331 MEADOR AVE J106 BELLINGHAM WA 98226 883460937 501(C)(3) 150000 0 COMMUNITY BENEFIT JOYCE L SOBEL FAMILY RES CTR PO BOX 1981 FRIDAY HARBOR WA 98250 912014083 501(C)(3) 100500 0 COMMUNITY BENEFIT SOUTHWEST WASHINGTON ACCOUNTABLE COMMUNITY OF HEALTH 2404 E MILL PLAIN BLVD SUITE B VANCOUVER WA 98661 462164971 501(C)(3) 100000 0 COMMUNITY BENEFIT COMMUNITY CONNECTIONS INC 721 STEDMAN ST KETCHIKAN AK 99901 920112719 501(C)(3) 100000 0 COMMUNITY BENEFIT NW YOUTH SERVICES 1020 N STATE ST BELLINGHAM WA 98225 910970561 501(C)(3) 97500 0 COMMUNITY BENEFIT LANE COUNTY OREGON 125 EAST 8TH AVENUE EUGENE OR 97401 936002303 GOVT 77500 0 HOUSING ASSISTANCE COUNCIL FOR THE HOMELESS 2500 MAIN STREET VANCOUVER WA 98660 912001828 501(C)(3) 75000 0 COMMUNITY BENEFIT CHUCKANUT HEALTH FDTN 1500 CORNWALL SUITE 201 BELLINGHAM WA 98225 911192943 501(C)(3) 70000 0 COMMUNITY BENEFIT ROAD2HOME PO BOX 3091 BELLINGHAM WA 98227 843552212 501(C)(3) 60000 0 COMMUNITY BENEFIT SAN JUAN ISLAND EMS 1079 SPRING STREET FRIDAY HARBOR WA 98250 911666544 501(C)(3) 55000 0 COMMUNITY BENEFIT BOYS AND GIRLS CLUB OF SNOHOMISH COUNTY 8223 BROADWAY SUITE 100 EVERETT WA 98203 910549511 501(C)(3) 55000 0 COMMUNITY BENEFIT CHOICE REGIONAL HEALTH NETWORK 1217 FOURTH AVE E OLYMPIA WA 98584 911704039 501(C)(3) 53000 0 COMMUNITY BENEFIT WESTERN LANE AMBULANCE DIST 2625 HWY 101 FLORENCE OR 97439 936010869 GOVT 50000 0 COMMUNITY BENEFIT UNITY CARE NW 1616 CORNWALL AVE STE 2015 BELLINGHAM WA 98225 912168190 501(C)(3) 50000 0 COMMUNITY BENEFIT BELLINGHAM FOOD BANK 1824 ELLIS ST BELLINGHAM WA 98225 910918619 501(C)(3) 48500 0 EDUCATION SUPPORT LYNDEN SCHOOL DISTRICT #504 516 MAIN ST LYNDEN WA 98264 911175139 GOVT 40000 0 COMMUNITY BENEFIT CLARK COWLITZ FIRE RESCUE 911 N 65TH AVE RIDGEFIELD WA 98642 911701275 GOVT 40000 0 COMMUNITY BENEFIT VOLUNTEERS IN MEDICINE CLINIC 2260 MARCOLA ROAD SPRINGFIELD OR 97477 931276816 501(C)(3) 37500 0 COMMUNITY BENEFIT CLARK COUNTY PO BOX 9825 VANCOUVER WA 98661 916001299 GOVT 35000 0 COMMUNITY BENEFIT OPPORTUNITY COUNCIL 1111 CORNWALL AVE BELLINGHAM WA 98225 910787820 501(C)(3) 31000 0 MISSION SUPPORT UNITED GENERAL DISTRICT 304 2031 HOSPITAL DR SEDRO WOOLLEY WA 98284 810622393 GOVT 27685 0 COMMUNITY BENEFIT EMERGENCY SUPPORT SHELTER 1330 11TH AVE LONGVIEW WA 98632 911074716 501(C)(3) 27000 0 COMMUNITY BENEFIT FOOD FOR LANE COUNTY 770 BAILEY HILL ROAD EUGENE OR 97402 930888347 501(C)(3) 25000 0 MISSION SUPPORT CATHOLIC CHARITIES 2740 SE POWELL BLVD 1 PORTLAND OR 97202 930386801 501(C)(3) 25000 0 COMMUNITY BENEFIT CLARK COUNTY SHERIFFS OFFICE CITIZEN SEARCH AND RESCUE TEAM 505 NW 179TH RIDGEFIELD WA 98642 602596667 501(C)(3) 25000 0 COMMUNITY BENEFIT YES FOR WHATCOM KIDS PO BOX 21961 SEATTLE WA 98111 883142999 501(C)(3) 25000 0 COMMUNITY BENEFIT CHAY ENVIRONMENTAL 22721 MAYGER HEIGHTS LANE CLATSKANIE OR 97016 472305448 501(C)(3) 25000 0 COMMUNITY BENEFIT INST FOR WASHINGTON FUTURE 2720 VALENCIA STREET BELLINGHAM WA 98226 910931421 501(C)(3) 25000 0 COMMUNITY BENEFIT COMMUNITY ACTION OF SKAGIT COUNTY 330 PACIFIC PLACE MT VERNON WA 98273 911140086 501(C)(3) 21000 0 COMMUNITY BENEFIT KETCHIKAN WELLNESS COALITION 602 DOCK ST STE 108 KETCHIKAN AK 99901 270897521 501(C)(3) 20675 0 COMMUNITY BENEFIT WHATCOM FAMILY YMCA 1256 N STATE ST BELLINGHAM WA 98225 910482690 501(C)(3) 20000 0 COMMUNITY BENEFIT TWIN SISTERS MARKET 3811 HATLEY RD EVERSON WA 98247 473583770 501(C)(3) 20000 0 COMMUNITY BENEFIT LOVE IN ACTION PO BOX 6371 - 1216 TONGASS AVENUE KETCHIKAN AK 99901 202913418 501(C)(3) 20000 0 COMMUNITY BENEFIT CHILDREN OF THE VALLEY 1318 S 18TH STREET MT VERNON WA 98274 262867395 501(C)(3) 20000 0 COMMUNITY BENEFIT YMCA OF COLUMBIA WILLAMETTE 9500 SW BARBUR BLVD PORTLAND OR 97219 930386981 501(C)(3) 18826 0 NUTRITION EDUCATION LOWER COLUMBIA SCHOOL GARDENS PO BOX 3010 LONGVIEW WA 98632 910823636 501(C)(3) 18770 0 EDUCATION SUPPORT COUNTY OF SOUTH LANE DIST 4553 1275 SOUTH RIVER RD COTTAGE GROVE OR 97424 936000589 GOVT 17500 0 COMMUNITY BENEFIT UNITED WAY OF WHATCOM COUNTY 1511 CORNWALL AVE BELLINGHAM WA 98225 910570788 501(C)(3) 15000 0 HOUSING ASSISTANCE FIRST CITY HOMELESS SVC PO BOX 23095 KETCHIKAN AK 99901 262565838 501(C)(3) 15000 0 COMMUNITY BENEFIT COMMUNITY FOUNDATION FOR SW WASHINGTON 610 ESTHER ST 201 VANCOUVER WA 98660 911246778 501(C)(3) 15000 0 HOUSING ASSISTANCE PARK AVENUE TEMPORARY HOME 628 PARK AVENUE PO BOX 9426 KETCHIKAN AK 99901 943109841 501(C)(3) 15000 0 COMMUNITY BENEFIT TRI PARRISH FOOD BANK 935 PETERSON ROAD BURLINGTON WA 98233 910871630 501(C)(3) 15000 0 EDUCATION SUPPORT LOWER COLUMBIA COLLEGE FDTN PO BOX 3010 1600 MAPLE ST LONGVIEW WA 98632 910823636 GOVT 10000 0 COMMUNITY BENEFIT SOUTH LANE MENTAL HEALTH SERVICES 410 N 9TH STREET COTTAGE GROVE OR 97424 930966461 501(C)(3) 10000 0 COMMUNITY BENEFIT HIV ALLIANCE 1195 CITY VIEW STREET EUGENE OR 97402 930963546 501(C)(3) 10000 0 COMMUNITY BENEFIT PARENTING NOW 88 CENTENNIAL LOOP EUGENE OR 97401 930706557 501(C)(3) 10000 0 COMMUNITY BENEFIT ECONOMIC DEVELOPMENT ALLIANCE OF SKAGIT COUNTY FOUNDATION 1932 E COLLEGE WAY SUITE B MT VERNON WA 98273 911724682 501(C)(3) 10000 0 COMMUNITY BENEFIT MULLIS COMMUNITY SENIOR CENTER PO BOX 684 FRIDAY HARBOR WA 98250 911057199 501(C)(3) 10000 0 COMMUNITY BENEFIT BIRCHWOOD NEIGHBORHOOD ASSOCIATION 2717 W MAPLEWOOD AVE BELLINGHAM WA 98225 201899229 501(C)(3) 10000 0 COMMUNITY BENEFIT STAAR OVARIAN CANCER 3835 CENTRAL AVE WESTERN SPRINGS IL 60558 844672869 501(C)(3) 10000 0 COMMUNITY BENEFIT BRING VANCOUVER HOME PO BOX 1322 VANCOUVER WA 98666 812064652 501(C)(3) 10000 0 COMMUNITY BENEFIT NW INDIAN COLLEGE FOUNDATION 2522 KWINA ROAD BELLINGHAM WA 98226 943057654 501(C)(3) 9500 0 COMMUNITY BENEFIT FLORENCE FARMERS MARKET 2006 HWY 101 FLORENCE OR 97439 842021387 501(C)(3) 8500 0 COMMUNITY BENEFIT PEACEHEALTH OREGON PO BOX 10905 EUGENE OR 97440 931084906 501(C)(3) 7500 0 COMMUNITY BENEFIT IDENTITY CLARK COUNTY 915 BROADWAY SUITE 302 VANCOUVER WA 98660 911623724 501(C)(3) 7500 0 COMMUNITY BENEFIT FAMILY PROMISE OF SKAGIT VALLEY PO BOX 335 SEDRO WOOLLEY WA 98284 462556043 501(C)(3) 7500 0 COMMUNITY BENEFIT SAN JUAN COUNTY ECONOMIC DEVELOPMENT COUNCIL PO BOX 3053 FRIDAY HARBOR WA 98250 412067708 501(C)(3) 7000 0 COMMUNITY BENEFIT BOYS AND GIRLS CLUB OF WESTERN 1501 AIRPLACE ROAD FLORENCE OR 97439 931236854 501(C)(3) 6900 0 COMMUNITY BENEFIT SIUSLAW OUTREACH SERVICES PO BOX 19000 FLORENCE OR 97439 943061005 501(C)(3) 6500 0 COMMUNITY BENEFIT JUBILEE WOMENS CENTER 620 18TH AVENUE EAST SEATTLE WA 98112 911539920 501(C)(3) 6000 0 COMMUNITY BENEFIT PEACEHEALTH KETCHIKAN MEDICAL CENTER 3100 TONGASS AVENUE KETCHIKAN AK 99901 920016490 501(C)(3) 6000 0 COMMUNITY BENEFIT HISPANIC METROPOLITAN CHAMBER PO BOX 1837 PORTLAND OR 97207 931156358 501(C)(3) 6000 0 COMMUNITY BENEFIT SOUTHEAST ALASKA INDEPENDENT LIVING 3225 HOSPITAL DRIVE STE 300 JUNEAU AK 99801 920144370 501(C)(3) 6000 0 COMMUNITY BENEFIT SOROPTIMIST INTL OF FLORENCE PO BOX 1209 FLORENCE OR 97439 237173303 501(C)(3) 5500 0 COMMUNITY BENEFIT ROTARY CLUB OF FLORENCE PO BOX 294 FLORENCE OR 97439 936032286 501(C)(4) 5049 0 COMMUNITY BENEFIT 83 0 PART I, LINE 2: PEACEHEALTH PRE-SCREENS APPLICANTS TO DETERMINE THE NEED OF THE ORGANIZATION RECEIVING THE GRANT. GRANTS AND DONATIONS ARE THEN DETERMINED AND GIVEN TO THOSE ORGANIZATIONS WHOSE MISSION FALLS IN LINE WITH PROMOTING HEALTHCARE OR THE FURTHERANCE OF A COMMUNITY NEED, SUCH AS HEALTHCARE EDUCATION. SINCE EACH GRANT IS CAREFULLY EXAMINED BEFORE IT IS GIVEN AND THE PURPOSE OF THE GRANT IS KNOWN BEFORE IT IS GIVEN, NO FOLLOW UP IS PERFORMED TO FIND OUT HOW THE GRANT WAS USED. X X X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 ELIZABETH V DUNNE PRESIDENT & CEO 1639763 0 1886230 0 28042 0 42920 0 14981 0 3611936 0 0 0 RICHARD DECARLO CHIEF OPERATING OFFICER/EVP 1012082 0 645129 0 11328 0 112772 0 24104 0 1805415 0 0 0 DARRIN MONTALVO EVP CHF FIN-GROWTH OFF/PART-YR TREAS 931496 0 593761 0 6303 0 193339 0 29953 0 1754852 0 0 0 JOLINE M TREANOR FORMER EVP PEOPLE AND CULTURE 23654 0 353320 0 978388 0 -1266 0 0 0 1354096 0 139004 0 MANJUNATH G RAJU MD CARDIOLOGY 1212488 0 0 0 0 0 54018 0 37248 0 1303754 0 0 0 WEN-HUAN S HO MD MD GASTROENTEROLOGY 1217697 0 0 0 0 0 50763 0 34018 0 1302478 0 0 0 STEVEN GLENN EVP CHIEF BUS. AND TECH OFFICER 704425 0 449144 0 22621 0 116094 0 5215 0 1297499 0 0 0 RON L SAXTON EVP GEN CSL/PART-YR SECRETARY 636195 0 559944 0 17067 0 42920 0 30207 0 1286333 0 0 0 DAVID SAENGER MD MD CARDIOLOGY 940888 0 220801 0 0 0 60782 0 35679 0 1258150 0 220801 0 MARK EICHLER MD GENERAL SURGERY 1131756 0 0 0 0 0 58086 0 32638 0 1222480 0 0 0 CHARLES PROSPER CHIEF EXECUTIVE NORTHWEST 681438 0 345923 0 9427 0 144216 0 34933 0 1215937 0 0 0 DOUGLAS KOEKKOEK CHIEF PHYS AND CLINICAL EXECUTIVE 727972 0 335998 0 9218 0 102364 0 23429 0 1198981 0 0 0 TODD SALNAS CHIEF EXECUTIVE OREGON 655026 0 334166 0 0 0 162340 0 32815 0 1184347 0 0 0 KARMAN TANDOM MD CARDIOLOGY 1087892 0 0 0 0 0 31618 0 32345 0 1151855 0 0 0 SEAN GREGORY MD CHIEF EXECUTIVE COLUMBIA 691875 0 352308 0 0 0 63230 0 34949 0 1142362 0 0 0 MICHAEL P DWYER EVP STRATEGY/COMMUNITY HEALTH 626918 0 399616 0 15802 0 62231 0 14145 0 1118712 0 0 0 MICHAEL C METCALF CHIEF EXECUTIVE PHMG 36144 0 848232 0 135824 0 4337 0 1827 0 1026364 0 678392 0 SARAH NESS EVP CAO 593671 0 192865 0 13376 0 110558 0 4292 0 914762 0 0 0 WILLIAM R WEIDER SVP CIO 471662 0 97617 0 3905 0 98332 0 37901 0 709417 0 0 0 MARK B HALLETT FORMER SVP CMO 0 0 48785 0 496994 0 0 0 0 0 545779 0 0 0 MARY E KINGSTON FORMER CHIEF EXECUTIVE OREGON 0 0 24410 0 468098 0 0 0 0 0 492508 0 0 0 CRAIG ARMSTRONG ASS GEN COUNSEL/ASST SEC 73478 0 22823 0 181570 0 8328 0 10782 0 296981 0 0 0 THOMAS KARNES SVP GEN CSL/PART-YRR SEC 217206 0 33719 0 0 0 3757 0 30799 0 285481 0 0 0 MICHELLE A JAMES SVP PATIENT CARE SVCS AND CNO 137312 0 80000 0 8172 0 0 0 7612 0 233096 0 0 0 JOHN C BENNETT FORMER CHIEF EXECUTIVE AMBULATORY 0 0 0 0 216348 0 0 0 0 0 216348 0 0 0 EVE LOGSDON SVP CHIEF HR OFFICER 142942 0 50000 0 0 0 0 0 5234 0 198176 0 0 0 KIM SULLIVAN SVP CHIEF REVENUE OFFICER 72310 0 50000 0 56579 0 0 0 1073 0 179962 0 0 0 PART I, LINE 1A THE ORGANIZATION HAS POLICIES REGARDING THE ELIGIBILITY OF EXECUTIVES FOR THESE ITEMS. FOR EXAMPLE, TRAVEL FOR COMPANIONS AND HOUSING ALLOWANCES ARE RELATED TO RELOCATION BENEFITS OR FIRST CLASS TRAVEL FOR FLIGHTS EXCEEDING SIX HOURS IN DURATION. THESE BENEFITS WERE REPORTED AND TREATED AS TAXABLE INCOME. PART I, LINES 4A-B THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, CERTAIN PHYSICIANS, AND OTHER HIGHLY COMPENSATED EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN VARIOUS NONQUALIFIED RETIREMENT PLANS. CONTRIBUTIONS TO THESE PLANS AND RELATED INVESTMENT RETURNS ARE DISCLOSED ON SCHEDULE J AS DEFERRED COMPENSATION AND AS BONUS COMPENSATION WHEN PAID TO THE INDIVIDUAL. THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR YEAR 2022: MARK B. HALLETT $496,994 JOHN C. BENNETT $216,348 MARY E. KINGSTON $468,098 CRAIG ARMSTRONG $182,662 JOLENE TREANOR $591,360 MICHAEL METCALF $135,540 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2022 (DEFERRED/PAID): ELIZABETH V. DUNNE: $0/$374,454 RICHARD DECARLO: $76,331/$0 RON SAXTON: $0/$154,416 MICHAEL P. DWYER: $25,411/$0 STEVEN GLENN: $73,174/$0 JOLINE M. TREANOR: $0/$280,152 WILLIAM R. WEIDER: $64,739/$0 MARK B. HALLETT: $0/$48,785 MICHAEL C. METCALF: $0/$795,597 MARY E. KINGSTON: $0/$24,410 CHARLES PROSPER: $119,816/$0 WEN-HUAN S. HO, M.D.: $20,043/$0 MARK EICHLER, M.D.: $27,366/$0 DAVID SAENGER, MD: $30,062/$220,801 KARMAN TANDON: $25,518/$0 MANJUNATH RAJU: $23,638/$0 SEAN GREGORY: $33,576/$0 SARAH NESS: $79,838/$0 DARRIN MONTALVO: $187,239/$0 TODD SALNAS: $144,040/$0 DOUGLAS KOEKKOEK: $99,314/$0 ADDITIONAL COMMENTARY WE ARE COMMITTED TO LIVING OUR CORE VALUES OF RESPECT, STEWARDSHIP, COLLABORATION AND SOCIAL JUSTICE. PEACEHEALTH MINISTRIES COMPETE FOR EXECUTIVE TALENT WITH BOTH FOR-PROFIT AND NON-PROFIT HOSPITALS AND HEALTH CARE SYSTEMS THROUGHOUT THE COUNTRY DUE TO THE COMPLEXITY OF THE JOB. COMPETITIVE COMPENSATION PROGRAMS ARE CRITICAL TO ATTRACT AND RETAIN THE BEST EXECUTIVE TALENT. PEACEHEALTH IS COMMITTED TO COMPENSATION PRACTICES THAT ARE BOTH JUST AND COMPETITIVE. PEACEHEALTH USES A SINGLE PROCESS TO DETERMINE COMPENSATION FOR ALL CAREGIVERS, INCLUDING EXECUTIVES. THIS PROCESS INCLUDES REVIEWING THIRD-PARTY SURVEY DATA TO BENCHMARK SALARIES AGAINST SIMILAR JOBS AT OTHER HEALTH CARE SYSTEMS OF COMPARABLE SIZE AND COMPLEXITY. WE ALSO EVALUATE EXECUTIVE PERFORMANCE ON AN ANNUAL BASIS. THE PEACEHEALTH BOARD HAS A GOVERNANCE COMMITTEE COMPRISED OF DIVERSE INDIVIDUALS WITH MISSION, INDEPENDENT BUSINESS AND HUMAN RESOURCES EXPERTISE. THE COMMITTEE IS CHARGED WITH SETTING EXECUTIVE COMPENSATION, INCLUDING INCENTIVE PAY, BENEFITS AND RELATED POLICIES. AS PART OF THE TOTAL COMPENSATION PACKAGE, OTHER BENEFITS ARE PROVIDED CONSISTENT WITH THE HEALTH CARE MARKET. BENEFITS ARE DESIGNED TO SUPPORT OUR CULTURE AND VALUES, AND TO ENCOURAGE COMMITMENT AND RETENTION. A WA HEALTHCARE FAC AUTH 911108929 NONEAVAIL 2013-02-27 53464898 REFUND WHCFA 2008A ISSUED 11/2008 0 0 0 B OR FACILITIES AUTHORITY 936001787 68608JSB8 2014-03-18 71088211 REFUND OFA08A&B '08, HHECFA '98 0 0 0 C OR FACILITIES AUTHORITY 2018 A 936001787 68608JXD8 2018-10-31 45975000 REFUND OFA 2008 A-B 0 0 0 D OR FACILITIES AUTHORITY 2018 B 936001787 68608JXF3 2018-10-31 100000000 REFUND OFA 2008 A-B 0 0 0 A 53464898 53464898 2013 1 0 1 1 B 71088211 1019562 70068649 2014 1 0 1 1 C 45975000 45975000 1 0 1 1 D 100000000 100000000 1 0 1 1 A 0 0 1 1 0 0.00010 0.00010 0 0 1 B 0 0 1 1 0 0.00010 0.00010 0 0 1 C 0 0 1 1 0 0.00010 0.00010 0 0 1 D 0 0 1 1 0 0.00010 0.00010 0 0 1 A 0 0 1 0 1 0 0 0 0 B 0 0 1 0 0 0 0 0 0 C 0 0 1 0 1 0 0 0 0 D 0 0 1 0 1 0 0 0 0 A 1 B 1 C 1 D 1 SCHEDULE K, PART III, LINES 3A AND 4 PERCENTAGE OF BOND FINANCED PROPERTY USED IN PRIVATE BUSINESS: A DE MINIMIS AMOUNT OF PRIVATE USE OCCURS. SCHEDULE K, PART III, LINES 8A, 8B AND 8C: DISPOSITION OF BOND-FINANCED PROPERTY: IN THE ORDINARY COURSE OF BUSINESS, PEACEHEALTH ROUTINELY DISPOSES OF PROPERTY. DISPOSALS ARE GENERALLY DUE TO EQUIPMENT OBSOLESCENCE OR A TRADE IN ON NEW EQUIPMENT. IN A DISPOSAL WHERE CASH PROCEEDS ARE RECEIVED, THE PROCEEDS ARE EITHER: 1) REINVESTED IN QUALIFIED ASSETS AT A LOCATION COVERED BY A TEFRA NOTICE (TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982), OR 2) BONDS ARE CALLED AND REDEEMED WITH THE PROCEEDS. A OR FACILITIES AUTHORITY 2018 C 936001787 NONEAVAIL 2018-12-03 75000000 REFUND OFA 2011 A 0 0 0 A 75000000 75000000 1 0 1 1 A 0 0 1 1 0 0.00010 0.00010 0 0 1 A 0 0 1 0 1 0 0 0 0 A 1 FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: CHARITY CARE AND COMMUNITY BENEFITS: PEACEHEALTH PROVIDES FINANCIAL ASSISTANCE TO PATIENTS UNABLE TO PAY FOR SERVICE. FINANCIAL ASSISTANCE PATIENTS RECEIVE CARE AT REDUCED COST OR NO CHARGE WHEN IT IS DETERMINED THAT PAYMENT CANNOT BE OBTAINED THROUGH INSURANCE, OUTSIDE AGENCIES, OR PRIVATE MEANS. PEACEHEALTH OFFERS INFORMATION ON AVAILABLE ASSISTANCE PRIOR TO ADMISSION, FINANCIAL ASSISTANCE IS ALSO AVAILABLE POST-CARE THROUGH FINANCIAL COUNSELING OTHER COMMUNITY BENEFIT COSTS INCLUDE THE UNREIMBURSED COST OF MEDICAID AND GOVERNMENT PROGRAMS, HEALTH EDUCATION, AND COMMUNITY HEALTH IMPROVEMENT INITIATIVES. NET COMMUNITY BENEFIT EXPENSE AND COMMUNITY BUILDING ACTIVITIES FOR TAX YEAR 2022 WAS $319,382,533 AND $62,183 RESPECTIVELY AS INDICATED ON THE SCHEDULE H IN PART I, LINE 7K COLUMN (E) AND PART II, LINE 10 COLUMN (E). FORM 990, PART VI, SECTION A, LINE 6 PEACEHEALTH NETWORKS (EIN: 91-1230425) IS THE SOLE CORPORATE MEMBER OF PEACEHEALTH. PEACEHEALTH NETWORKS IS A 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S ACCOUNTING DEPARTMENT WORKS CLOSELY WITH THE OUTSIDE ACCCOUNTING FIRM IT ENGAGES (KPMG) TO PREPARE AND REVIEW THE RETURN. THE EVP, CFO AND LEGAL DEPARTMENT REVIEW A DRAFT OF THE FORM 990 AND PROVIDE COMMENTS. THE FINAL DRAFT IS MADE AVAILABLE TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C A FORMAL CONFLICT OF INTEREST QUESTIONNAIRE IS DISTRIBUTED TO PEACEHEALTH BOARD MEMBERS AND OFFICERS AT LEAST ANNUALLY. RESPONSES ARE REVIEWED BY THE PEACEHEALTH ORGANIZATIONAL INTEGRITY DEPARTMENT AND ANY PERCEIVED OR REAL CONFLICTS OF CONCERN ARE DOCUMENTED IN A MANAGEMENT PLAN AND REVIEWED BY NETWORK AND BOARD LEADERSHIP. BOARD MEMBERS AND OFFICERS ARE OBLIGATED TO BRING ANY CHANGES IN STATUS VIS-A-VIS THE CONFLICT OF INTEREST POLICY TO THE BOARD'S ATTENTION FOR REVIEW AND DISPOSITION BETWEEN SURVEY PERIODS. IF PEACEHEALTH ORGANIZATIONAL INTEGRITY BELIEVES A DISCLOSURE POSES A POTENTIAL OR ACTUAL CONFLICT, IT MUST INDICATE TO THE COVERED PERSON HOW TO DISPOSE OF OR MANAGE THE CONFLICT. PEACEHEALTH ORGANIZATIONAL INTEGRITY INVOLVES LEADERS FROM OTHER DEPARTMENTS AS NEEDED TO REVIEW AND MANAGE DISCLOSED CONFLICTS OF INTEREST. IF PEACEHEALTH HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST OR OTHERWISE VIOLATED THIS POLICY OR REFUSED TO COOPERATE IN AN INVESTIGATION RELATED TO COMPLIANCE WITH THIS POLICY, IT MUST INFORM THE PERSON OF THE BASIS FOR THE BELIEF AND AFFORD AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF AFTER HEARING THE RESPONSE AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, PEACEHEALTH DETERMINES A PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT MAY TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION UP TO AND INCLUDING DISSOLUTION OF THE PERSON'S AFFILIATION WITH PEACEHEALTH. FORM 990, PART VI, SECTION B, LINE 15 THE INDEPENDENT CHAIR OF THE PEACEHEALTH BOARD OF DIRECTORS REVIEWS AND RECOMMENDS, IN PARTNERSHIP WITH REPRESENTATIVES OF AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT RETAINED BY THE BOARD OF DIRECTORS, THE COMPENSATION OF PEACEHEALTH'S PRESIDENT/CHIEF EXECUTIVE OFFICER. THE BOARD OF DIRECTORS HAS ULTIMATE APPROVAL AUTHORITY FOR THE COMPENSATION FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER. FURTHERMORE, THE INDEPENDENT COMPENSATION CONSULTANT, WITH SUPPORT FROM MEMBERS OF THE HUMAN RESOURCES DEPARTMENT, DETERMINES COMPARABILITY DATA ACROSS VARIOUS INDUSTRY AND APPLICABLE FOR-PROFIT/NOT-FOR-PROFIT ORGANIZATIONS FOR PERIODICALLY INFORMING THE GOVERNANCE COMMITTEE OF THE BOARD ON THE MARKET COMPETITIVENESS OF THE PAY FOR PEACEHEALTH EXECUTIVES. DISCUSSIONS AND DECISIONS MADE DURING THE COMMITTEE MEETINGS ARE DOCUMENTED IN MEETING MINUTES. THE MOST RECENT COMPENSATION REVIEW WAS COMPLETED IN SEPTEMBER 2022, AND INCLUDED THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, NETWORK CHIEF EXECUTIVES, MEDICAL GROUP CHIEF EXECUTIVE, AND OTHER SENIOR NETWORK ROLES (INCLUDING CFO, COO, CAO). FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE ON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAPS 14,133,032. CHANGE IN INTEREST IN NET ASSETS OF RELATED FOUNDATION 10,164,297. CHANGE IN PENSION LIABILITY 125,883. CHANGE IN VALUE OF NET ASSETS OF AFFILIATE 33,551,712. OTHER CHANGE IN FUND BALANCE -413,270. INTERCOMPANY TRANSFER -976,818. ZOOM MANUFACTURING LLC 1115 SE 164TH AVE VANCOUVER WA 98683 861967518 SALES WA -184227 -8259200 PEACEHEALTH PEACEHEALTH NETWORKS 1115 SE 164TH AVENUE VANCOUVER WA 98683 911230425 SUPPORT WA 501(C)(3) LINE 12B, II N/A 0 PEACEHEALTH SW MEDICAL CENTER FDN PO BOX 1600 VANCOUVER WA 98668 911231436 FUNDRAISING WA 501(C)(3) LINE 7 PEACEHEALTH 1 HEALTH VENTURES 1115 SE 164TH AVENUE VANCOUVER WA 98683 911350776 HEALTHCARE JV WA 501(C)(3) LINE 12A, I PEACEHEALTH 1 KETCHIKAN MEDICAL CENTER FDN 3100 TONGASS AVENUE KETCHIKAN AK 99901 651225184 FUNDRAISING AK 501(C)(3) LINE 7 PEACEHEALTH 1 COTTAGE GROVE MEDICAL CENTER FDN 1515 VILLAGE DRIVE COTTAGE GROVE OR 97424 930688381 FUNDRAISING OR 501(C)(3) LINE 7 PEACEHEALTH 1 PEACE HARBOR MEDICAL CENTER FDN 400 NINTH STREET FLORENCE OR 97439 931084126 FUNDRAISING OR 501(C)(3) LINE 7 PEACEHEALTH 1 SACRED HEART MEDICAL CENTER FDN PO BOX 10905 EUGENE OR 97440 936026548 FUNDRAISING OR 501(C)(3) LINE 7 PEACEHEALTH 1 ST JOHN MEDICAL CENTER FDN 1615 DELAWARE STREET PO BOX 3 LONGVIEW WA 98632 911538852 FUNDRAISING WA 501(C)(3) LINE 7 PEACEHEALTH 1 ST JOSEPH MEDICAL CENTER FDN 2901 SQUALICUM PARKWAY BELLINGHAM WA 98225 721545902 FUNDRAISING WA 501(C)(3) LINE 7 PEACEHEALTH 1 RB AMBULATORY SURGERY CENTER 3355 RIVERBEND DR SPRINGFIELD OR 97477 MEDICAL OR N/A 0 0 ARDON HEALTH HOLDINGS LLC 601 SW 2ND AVENUE 24TH FLOOR PORTLAND OR 97204 821561337 PHARMACY DE PEACEHEALTH 4602666 0 0 0.35000 CLARE REASSURANCE 1115 SE 164TH AVE VANCOUVER WA 98683 981560395 REINSURANCE CJ PH NETWORKS C 0 LOWER COLUMBIA REGION POOLED INCOME FUND 1115 SE 164TH AVE VANCOUVER WA 98683 466157497 POOLED INC FUND WA PEACEHEALTH T 100535 1834673 1.00000 0 OREGON REGION POOLED INCOME FUND 1115 SE 164TH AVE VANCOUVER WA 98683 466180599 POOLED INC FUND WA PEACEHEALTH T 118869 6293104 1.00000 0 PEACEHEALTH AMBULATORY LLC 1115 SE 164TH AVE VANCOUVER WA 98683 862027568 MEDICAL WA PH NETWORKS C 0 PEACEHEALTH CLINICALLY INTEGRATED NETWORK 1115 SE 164TH AVE VANCOUVER WA 98683 861975269 MEDICAL WA PH AMBULATORY LLC C 0 PEACEHEALTH DIRECT CONTRACTING LLC 1115 SE 164TH AVE VANCOUVER WA 98683 861344009 MEDICAL WA PH AMBULATORY LLC C 0 PEACEHEALTH NETWORKS ON DEMAND LLC 1115 SE 164TH AVE VANCOUVER WA 98683 832849989 MEDICAL CLINICS WA PH NETWORKS C 0 POOLED INCOME FUND OF PEACEHEALTH #1 1115 SE 164TH AVE VANCOUVER WA 98683 276030191 POOLED INC FUND WA PEACEHEALTH T 913809 10160315 1.00000 0 SIUSLAW REGION POOLED INCOME FUND 1115 SE 164TH AVE VANCOUVER WA 98683 466221760 POOLED INC FUND WA PEACEHEALTH T 92952 1933480 1.00000 0 SOUTHWEST REGION POOLED INCOME FUND 1115 SE 164TH AVE VANCOUVER WA 98683 466168710 POOLED INC FUND WA PEACEHEALTH T 198442 5014908 1.00000 0 WHATCOM REGION POOLED INCOME FUND 1115 SE 164TH AVE VANCOUVER WA 98683 466129451 POOLED INC FUND WA PEACEHEALTH T 207794 3578983 1.00000 0 0 0 1 0 0 0 1 0 0 0 0 1 0 1 1 1 0 1 1 HEALTH VENTURES C 10000000 AT COST PEACEHEALTH POOLED INCOME FUNDS R 1380124 AT COST PEACEHEALTH POOLED INCOME FUNDS S 738180 AT COST RELATED FOUNDATIONS N 63500 AT COST RELATED FOUNDATIONS O 924933 AT COST RELATED FOUNDATIONS P 373686 AT COST SCHEDULE R, PART IV: SPLIT INTEREST TRUSTS DISCLOSURE PEACEHEALTH HAS FORMED SEVERAL SPLIT INTEREST TRUSTS. THE TRUSTS ARE LISTED AS POOLED INCOME FUNDS ON THE SCHEDULE R, PART IV. THESE ENTITIES ACQUIRED PROPERTY FROM PEACEHEALTH IN SALE LEASE-BACK TRANSACTIONS CREATING A CAPITAL LEASE OBLIGATION. DURING THE YEAR A SERIES OF TRANSACTIONS OCCURRED BETWEEN PEACEHEALTH AND THE SPLIT INTEREST TRUSTS INCLUDING: 1) $2.2 MILLION IN RENT PAYMENTS FROM PEACEHEALTH TO THE SPLIT INTEREST TRUSTS AND 2) SPLIT INTEREST TRUSTS MADE $738,180 IN INTEREST AS PAYMENT ON DEBT TO PEACEHEALTH. AS OF 06/30/2023, THE SPLIT INTEREST TRUSTS HAVE A LIABILITY TO THE DONORS OF CERTAIN INTERESTED PERSONS AND OTHERS ENGAGED IN TRANSACTIONS WITH THE SPLIT INTEREST TRUSTS. DURING THE CURRENT FISCAL YEAR THESE INDIVIDUALS CONTRIBUTED NO MONEY TO THE SPLIT INTEREST TRUSTS. THE SPLIT INTEREST TRUSTS PAID IN AGGREGATE TO THESE INDIVIDUALS $117,353. UPON THE DEATH OF THE INDIVIDUAL, AND OR THEIR SUCCESSOR, THEIR OWNERSHIP INTERESTS IN THESE SPLIT INTEREST TRUSTS WILL REVERT BACK TO PEACEHEALTH.