2025-10-28T14:49:21-05:00 2024-12-31 346565596 ERNST & YOUNG US LLP 221 EAST 4TH STREET STE 2900 CINCINNATI OH 45202 990 2024-01-01 910567263 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION YAKI 5095758000 2811 TIETON DRIVE YAKIMA WA 989023799 MAX OWENS CFO YAKIMA MEMORIAL HOSPITAL 5095758000 2025-10-28 0 1 ABBEY E LEIBEL P01517527 5136121400 2024 2025-03-06 01:10:19Z MULTICARE YAKIMA MEMORIAL HOSPITAL TAMMY BUYOK 2811 TIETON DRIVE YAKIMA WA 989023799 714830824 0 X MULTICARE.ORG/LOCATION/YAKIMA-MEMORIAL-HOSPITAL/ X 1950 WA PARTNERING LOCALLY TO SUPPORT THE COMMUNITIES WE SERVE IN THE WAYS THEY NEED IT MOST. (SEE SCH O) (CONTINUATION FROM PAGE 1) BECAUSE HEALTHY COMMUNITIES NEED MORE THAN HEALTH CARE. 11 10 2730 90 18231 0 11665703 10522946 537154263 632981212 1403213 -5794132 3109577 9322991 553332756 647033017 1761404 2107265 0 0 289802819 337874335 0 0 0 280691968 305699382 572256191 645680982 -18923435 1352035 462075289 567678529 192498036 299864875 269577253 267813654 X PARTNERING LOCALLY TO SUPPORT THE COMMUNITIES WE SERVE IN THE WAYS THEY NEED IT MOST. BECAUSE HEALTHY COMMUNITIES NEED MORE THAN HEALTH CARE. 0 0 522303968 2107265 612298187 OUTPATIENT/INPATIENT SERVICES- YAKIMA VALLEY MEMORIAL HOSPITAL (YVMH) OPERATES A 238 LICENSED ADULT BEDS SERVING THE COMMUNITIES IN CENTRAL WASHINGTON. DESIGNATED AS THE ONLY LEVEL 3 ADULT AND PEDIATRIC TRAUMA CENTER IN A THREE-COUNTY REGION, YVMH IS HOME TO A WIDE RANGE OF SERVICES TO HELP ADDRESS THE DIVERSE NEEDS OF ITS' COMMUNITY. THROUGH NORTH STAR LODGE THE HOSPITAL OFFERS CANCER CARE AND BREAST HEALTH AT THE 'OHANA MAMMOGRAPHY CENTER, HOSPICE SERVICES IN-HOME, PAIN MANAGEMENT AT WATER'S EDGE, AND COMPREHENSIVE SERVICES FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AT CHILDREN'S VILLAGE. IN 2024 YVMH ADMITTED 13,577 PATIENTS FOR A TOTAL OF 60,348 PATIENT DAYS, PERFORMED 7,432 SURGERIES AND DELIVERED 2,524 BABIES. THERE WERE 3,574 NEWBORN DAYS. DURING 2024 YVMH PROVIDED 226,756 OUTPATIENT VISITS (SEE SCH O)(CONTINUATION FROM PAGE 2) AND 49,234 EMERGENCY ROOM VISITS. THE HOSPITAL PROCESSED 1,819,844 LABORATORY WORKLOAD UNITS AND 165,456 IMAGING RELATIVE UNITS. DURING 2024 THE HOSPITAL PROCESSED 38,307 ONCOLOGY RELATIVE VALUE UNITS, 44,407 RADIATION ONCOLOGY VALUE UNITS, 11,250 ONCOLOGY PROCEDURES AND 3,994 PHARMACY WORKLOAD UNITS. 15600948 18288484 PRIMARY CARE, SPECIALIZED CLINICS, FACILITIES FOR DIAGNOSIS AND TREATMENT- CLINICS COVER A LOT OF GROUND IN HEALTHCARE. YAKIMA VALLEY MEMORIAL HOSPITAL (YVMH) OPERATES OVER TWENTY-FOUR CLINICS THAT ARE OFFERING SURGERY, PRIMARY CARE, URGENT CARE, SPECIALTY CARE, CANCER CARE, DIAGNOSTIC TESTING, IMAGING AND OTHER VARIOUS THERAPEUTIC SERVICES. IN 2024, THE PHYSICIAN OFFICES PROVIDED 170,191 PHYSICIAN VISITS, THE SPECIALIZED THERAPHY CLINICS PROVIDED 8,110 THERAPHY-15 MINUTE INCREMENTS AND DELIVERED 273,462 THERAPY PROCEDURES. 2058210 2394541 POPULATION HEALTH, BEHAVIORAL HEALTH AND OTHERS. YAKIMA VALLEY MEMORIAL HOSPITAL (YVMH) OPERATES OTHER PROGRAMS SUCH AS POPULATION HEALTH, BEHAVIORAL HEALTH, HOME HEALTH AND HOSPICE SERVICES , MEDICAL ACADEMICS AND MEDICAL RESIDENCY. IN 2024 YAKIMA VALLEY MEMORIAL HOSPITAL PERFORMED 9,898 HOME HEALTH VISITS, PROVIDED 919 HOSPICE ADMITS AND PROVIDED 569 PSHYCHOLOGY CTU RVUS. 539963126 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 0 0 1 225 0 1 2730 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WA X WALTER HEFNER 5097463571 2811 TIETON DRIVE YAKIMA WA 989023799 DAVID HARGREAVES CHAIRMAN 2.00 0.00 X X 0 0 0 GAIL WEAVER VICE CHAIRMAN 2.00 0.00 X X 0 0 0 MARIBEL JIMINEZ DIRECTOR 2.00 0.00 X 0 0 0 STEPHEN RUPP DIRECTOR 2.00 0.00 X 0 0 0 CYNTHIA JUAREZ SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 PATRICK OSHIE DIRECTOR 2.00 0.00 X 0 0 0 MIRNA RAMOS-DIAZ DIRECTOR 2.00 0.00 X 0 0 0 ROBERT WILLIAMS DIRECTOR 2.00 0.00 X 0 0 0 DOUGLAS ELLISON DIRECTOR 2.00 0.00 X 0 0 0 LAURA ARMSTRONG DIRECTOR 2.00 0.00 X 0 0 0 LORI ARVISO ALVORD DIRECTOR 2.00 0.00 X 0 0 0 TAMMY BUYOK PRESIDENT & YAKIMA MARKET LEADER 30.00 10.00 X 0 626888 38599 MAXWELL OWENS CFO 40.00 0.00 X 165654 0 4146 NATHANIEL DAVENPORT CHIEF MEDICAL OFFICER 40.00 0.00 X 432208 0 69298 SCOTT JONES CHIEF OPERATIONS OFFICER 40.00 0.00 X 349450 0 20679 KIMBERLY BERSING COO & CHIEF NURSING EXECUTIVE 40.00 0.00 X 330188 0 42143 LUCAS FAYEZ BAZI PHYSICIAN 40.00 0.00 X 1177010 0 45155 SAURABH RANJAN PHYSICIAN 40.00 0.00 X 1118768 0 27052 SIVA MANNEM PHYSICIAN 40.00 0.00 X 924422 0 47185 JEFFREY BUSHMAN PHYSICIAN 40.00 0.00 X 887659 0 47359 HARMANJOT GILL PHYSICIAN 40.00 0.00 X 854914 0 40305 6240273 626888 381921 956 0 1 0 EMERGENCY ASSOCIATES OF YAKIMA PLLC 2811 TIETON DRIVE YAKIMA WA 98902 MEDICAL AND HEALTHCARE 14644023 SIMPLI FI MANAGED SERVICES PO BOX 631820 CINCINNATI OH 45263 MEDICAL SERVICES 12440061 LOCUMSMART LLC 315 WEST 36TH STREET NEW YORK NY 10018 MEDICAL SERVICES 8998236 ORTHOPEDICS NORTHWEST PLLC PO BOX 2309 YAKIMA WA 98907 MEDICAL AND HEALTHCARE 7633230 YAKIMA UROLOGY ASSOCIATES PLLC 2500 RACQUET LANE SUITE 100 YAKIMA WA 98902 MEDICAL AND HEALTHCARE 7337701 66 2534611 7787444 200891 10522946 NET PATIENT REVENUE 621400 630568440 630568440 POPULATION HEALTH 541611 2394541 2394541 COMMUNITY LAB 621500 18231 18231 632981212 789509 912678 -123169 -123169 -123169 9335 61081662 0 66885129 9335 -5803467 -5794132 -5794132 CAFETERIA,DAYCARE 923120 9446160 9446160 9446160 647033017 632962981 18231 3528859 2107265 2107265 1413767 1413767 243649 243649 288386271 260846811 27539460 26775580 26775580 21055068 17098343 3956725 898571 898571 1333926 984721 349205 400795 400795 35579491 22828354 12751137 290365 25441 264924 7951127 1135024 6816103 21172200 7986199 13186001 11156810 8948331 2208479 854983 525721 329262 3336374 4351 3332023 17364444 1768283 15596161 2380007 28570 2351437 SUPPLIES 127063592 124356661 2706931 PROFESSIONAL FEES 35321544 33926579 1394965 SAFETY NET 20229882 20229882 UTILITIES, WASTE, HOUSE 8425742 4835182 3590560 11939529 5551828 6387701 645680982 539963126 105717856 0 79514024 142453376 71075453 143623750 16861866 0 9412250 9103155 3782600 3342420 298432624 43748249 241446644 254684375 922336 2646898 7439467 7182933 28973751 7288520 462075289 567678529 113247649 114013226 6059743 8799600 138214 0 73052430 177052049 192498036 299864875 X 265621767 4753691 3955486 263059963 269577253 267813654 462075289 567678529 X 1352035 6157498 -9273132 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 26841021 26841021 137151673 12883122 124268551 9275414 22028211 -12752797 96257748 8836916 87420832 28906768 28906768 254684375 DUE TO AFFILIATES 156927049 LT DEBT 20125000 177052049 X PART X, LINE 2: YAKIMA VALLEY MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MULTICARE HEALTH SYSTEM (MHS). THE FOOTNOTE ON THE CONSOLIDATED FINANCIAL STATEMENTS READS: "ASC SUBTOPIC 740-10, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN MHS' CONSOLIDATED FINANCIAL STATEMENTS. THIS TOPIC ALSO PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ONLY TAX POSITIONS THAT MEET THE "MORE-LIKELY THAN-NOT" RECOGNITION THRESHOLD AT THE EFFECTIVE DATE MAY BE RECOGNIZED OR CONTINUE TO BE RECOGNIZED UPON ADOPTION. IN ADDITION, THIS TOPIC PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. OTHER THAN MEDIS, INC., PHYSICIANS OF SOUTHWEST WASHINGTON, LLC AND OLYMPIC SPORTS & SPINE, PLLC, WHICH ARE ALL TAXABLE ENTITIES, ALL OF THE OTHER ENTITIES HAVE OBTAINED DETERMINATION LETTERS FROM THE INTERNAL REVENUE SERVICE THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME." 1 1 X 1 X 300.000000000000 1 X 500.000000000000 1 1 0 1 1 15039659 15039659 0.02340 168766000 133888000 34878000 0.05430 183805659 133888000 49917659 0.07770 1489455 357448 1132007 0.00180 3952537 1644532 2308005 0.00360 15855992 9796983 6059009 0.00940 193478 193478 0.00030 21491462 11798963 9692499 0.01510 205297121 145686963 59610158 0.09280 178433 0 178433 0.00030 178433 178433 0.00030 1 2807790 0 32258726 39929183 -7670457 X 1 1 1 1 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION 2811 TIETON DRIVE YAKIMA WA 98902 WWW.MULTICARE.ORG/LOCATION/YAKIMA-MEMO HAC.FS.00000058 X X X X YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIAT 1 0 0 1 X X X X X X X X X X 22 1 0 1 1 X HTTPS://WWW.MULTICARE.ORG/ABOUT/COMMUNITY/NEEDS-ASSESSMENT/ X 1 22 1 HTTPS://WWW.MULTICARE.ORG/ABOUT/COMMUNITY/NEEDS-ASSESSMENT/ 0 1 X 300.000000000000 500.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.MULTICARE.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MULTICARE.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE/FO X HTTPS://WWW.MULTICARE.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 3J: BASED ON THE FINDINGS FROM THE 2022 CHNA, THE FOLLOWING THREE AREAS WERE IDENTIFIED AS SIGNIFICANT COMMUNITY HEALTH NEEDS WITHOUT PRIORITIZATION: 1. ACCESS TO CARE 2. HEALTH EQUITY3. BEHAVIORAL HEALTH YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: YAKIMA VALLEY MEMORIAL HOSPITAL'S (MEMORIAL) 2022 CHNA INCLUDED A ROBUST, COLLABORATIVE COMMUNITY CONVENING PROCESS TO REVIEW COMMUNITY NEEDS AND DISCUSS PRIORITIES. THE PROCESS INCLUDED A COMMUNITY ENGAGEMENT SURVEY AND LISTENING SESSIONS IN WHICH NEARLY 800 COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, AND MEMORIAL STAFF PARTICIPATED IN TO PRIORITIZE SERVICE GAPS AND UNMET NEEDS. MEMORIAL DISTRIBUTED AN ONLINE SURVEY THROUGH COMMUNITY PARTNERS (INCLUDING THE YAKIMA HEALTH DISTRICT), SOCIAL MEDIA,STAFF, AND PROVIDERS, RECEIVING NEARLY 700 COMPLETED SURVEYS. MEMORIAL'S COMMUNITY ENGAGEMENT PROCESS ALSO INCLUDED TEN LISTENING SESSIONS, WITH NINE DIFFERENT ORGANIZATIONS AND PARTNERS, INVOLVING ABOUT 90 PARTICIPANTS. NINE SESSIONS WERE HELD IN-PERSON AND ONE WAS VIRTUAL. EACH SESSION LASTED, ON AVERAGE, 60-90 MINUTES AND FOCUSED ON IDENTIFYING THE GREATEST GAPS, DISPARITIES, AND UNMET HEALTH CARE NEEDS IN YAKIMA COUNTY.A FULL LIST OF PARTNERS IS INCLUDED IN THE COMMUNITY HEALTH NEEDSASSESSMENT AND CAN BE FOUND ON MEMORIAL'S WEBSITE:WWW.MULTICARE.ORG/ABOUT/COMMUNITY/NEEDS-ASSESSMENT/ YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: YAKIMA COUNTY HEALTH DEPARTMENT YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: YAKIMA VALLEY MEMORIAL HOSPITAL (MEMORIAL) HAS OUTLINED IN THE IMPLEMENTATION PLAN 2023-2025 HOW THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. THE IMPLEMENTATION PLAN IS A MULTI-YEAR GUIDE TO IMPROVING THE HEALTH STATUS OF OUR COMMUNITY AND TARGETS THE PRIORITIZED AREAS AND GAPS IN HEALTH NEEDS THAT HAVE BEEN IDENTIFIED. AS A RESULT OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, HEALTH PRIORITIES WERE SELECTED, AND MEMORIAL HAS DEVELOPED AN ACTION PLAN OUTLINED IN THE IMPLEMENTATION PLAN TO ADDRESS THE THREE PRIORITIES AND POSITIVELY INFLUENCE THE HEALTH AND WELL-BEING OF THE COMMUNITY. MEMORIAL WILL ADDRESS THE THREE SIGNIFICANT NEEDS IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT BY CONTINUING AND STRENGTHENING EXISTING PROGRAMS AND SERVICES; EXPLORING THE IMPLEMENTATION OF NEW STRATEGIES, PROGRAMS, OR SERVICES; PROVIDING LEADERSHIP IN COLLABORATION WITH COMMUNITY ORGANIZATIONS TO IMPLEMENT EVIDENCE-BASED STRATEGIES ACROSS THE SERVICE AREA. THE IMPLEMENTATION PLAN OUTLINES BOTH INTERNAL AND COMMUNITY-WIDE OBJECTIVES AND STRATEGIES UNDER EACH OF THE PRIORITY AREAS AS WELL AS SPECIFIC MEASUREMENTS THAT WILL BE USED TO EVALUATE OUR PROGRESS. THE IMPLEMENTATION PLAN 2023-2025 WAS ADOPTED BY THE MEMORIAL BOARD OF DIRECTORS IN NOVEMBER 2022. ALL THREE PRIORITIES CALLED OUT AND LISTED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT ARE BEING ADDRESSED.ACCESS TO HEALTH CAREMEMORIAL PRIORITIZES STABILIZING ITS WORKFORCE AND INCREASING ACCESS TO PREVENTATIVE, DIAGNOSTIC, AND TREATMENT SERVICES. MEMORIAL PARTNERS WITH LOCAL COMMUNITY COLLEGES AND HEALTH PROFESSION EDUCATION PROGRAMS TO MENTOR AND TRAIN ON-SITE LOCAL HEALTH PROFESSIONALS FROM COLLEGE PROGRAMS ACROSS THE COUNTY AND STATE. THIS ALLOWS STUDENTS TO PRACTICE IN THEIR RESPECTIVE FIELD OF STUDY AS REQUIRED TO COMPLETE THEIR DEGREE AND SIT FOR ASSOCIATED EXAMS. AFTER TRAINING AND COMPLETION OF COURSEWORK, EACH HEALTH PROFESSIONAL IS READY FOR THE WORKFORCE AND TO FILL MUCH-NEEDED VACANCIES WITHIN THE COMMUNITY. MEMORIAL PRIORITIZES GROWING A LOCAL WORKFORCE AND IMPROVING PHYSICIAN/STAFF ENGAGEMENT BY BUILDING ON SYSTEM-LEVEL MULTICARE RECRUITMENT STRUCTURES AND STRATEGIES. MEMORIAL CONTINUES TO EXPAND TALENT PIPELINES THROUGH RESIDENCY PROGRAMS, INCREASED AVAILABILITY OF CLINICAL ROTATIONS, AND OUTREACH TO COMMUNITY GROUPS. MEMORIAL ALSO PROVIDES A NUMBER OF OPPORTUNITIES FOR CONTINUING MEDICAL EDUCATION PROGRAMMING EACH YEAR TO SERVE MEDICAL PROFESSIONALS ACROSS THE COMMUNITY, ALLOWING THEM TO RENEW LICENSES AND CONTINUE TO PRACTICE IN YAKIMA COUNTY. MEMORIAL IS SEEKING OUT PARTNERSHIPS TO BRING NEW PROGRAMS TO PNWU FOR ALLIED HEALTH PROGRAMS. MEMORIAL IS FOCUSED ON INCREASING PREVENTATIVE CARE AND REDUCING AVOIDABLE EMERGENCY DEPARTMENT VISITS. THIS INCLUDES PARTNERING WITH COMMUNITY PROVIDERS TO INCREASE EVIDENCE-BASED SCREENINGS, INCREASING PREVENTATIVE SCREENING OFFERINGS, STRENGTHENING TRANSITIONS OF CARE, AND PARTNERING WITH COMMUNITY CLINICS TO ENSURE PATIENTS HAVE A PRIMARY CARE HOME. AN IMPORTANT PIECE OF INCREASING ACCESS TO CARE IS MAINTAINING COMMON ELECTRONIC RECORDS AND IMPROVING EFFICIENCIES FOR PATIENT SCHEDULING AND REFERRALS. MEMORIAL HAS IMPLEMENTED EPIC TO IMPROVE ACCESS TO PATIENT INFORMATION. THIS INCLUDES IMPLEMENTING MYCHART ACCESS FOR PATIENTS THAT ENABLES MORE ENGAGEMENT WITH THEIR CARE TEAM, SCHEDULING, AND RESULTS. MEMORIAL IS WORKING TO IMPLEMENT INTERNAL REVIEWS OF OUTMIGRATION OPPORTUNITIES AND EDUCATING LOCAL HEALTHCARE PROVIDERS ABOUT YAKIMA SERVICE OFFERINGS FOR SPECIALTY SERVICES, CARE, AND TREATMENT. MEMORIAL ALSO PROVIDES SUPPORT AND PARTNERS WITH UNION GOSPEL MISSION (UGM) MEDICAL CARE CENTER FREE CLINIC, WHICH IS FOCUSED ON PROVIDING ACCESS TO PRIMARY CARE, LAB, IMAGING, AND SPECIALTY SERVICES FOR UNINSURED/UNDERINSURED POPULATIONS.OUR REGION'S FIRST INDIGO URGENT CARE AND MULTICARE OCCUPATIONAL MEDICINE CLINIC OPENED, SERVING OVER 7,500 PATIENTS, AND A NEW NEIGHBORHOOD EMERGENCY DEPARTMENT IN UNION GAP BROKE GROUND. TO MEET RISING DEMAND, WE GREW INPATIENT CAPACITY FROM 100 TO 168 BEDS, INCREASED HOME HEALTH & HOSPICE ACCESS BY 15%, AND IMPROVED IMAGING AVAILABILITY. THESE IMPROVEMENTS WERE MADE POSSIBLE BY A GROWING TEAM-INCLUDING 20 NEW PHYSICIANS, 10 PHYSICIAN ASSISTANTS, AND 108 REGISTERED NURSES.HEALTH EQUITYMEMORIAL IS WORKING TO EXPAND OPPORTUNITIES FOR ALL COMMUNITY MEMBERS BY INCREASING TRAINING OFFERINGS AND PARTICIPATION IN CULTURAL COMPETENCY AND HEALTH EQUITY. THIS INCLUDES IDENTIFYING AND DEVELOPING LEADERS FROM VARIOUS BACKGROUNDS AND ENHANCING WORKFORCE REPRESENTATION. MEMORIAL IS INCORPORATING THESE PRINCIPLES INTO OPERATIONAL PROCESSES AND TOOLS AND EXPANDING ITS NETWORK FOR RECRUITING STUDENTS FROM UNDERREPRESENTED COMMUNITIES. MEMORIAL IS IN THE PROCESS OF EMBEDDING AND REPORTING METRICS BY RACE, ETHNICITY, AND LANGUAGE TO IDENTIFY HEALTH DISPARITIES AND COLLABORATING WITH PARTNERS TO IMPLEMENT ACTION PLANS.BEHAVIORAL HEALTHMEMORIAL HAS ESTABLISHED INTERVENTION STRATEGIES TO PROMOTE MENTAL WELL-BEING AND PREVENT MENTAL HEALTH DISORDERS. THIS INCLUDES STANDARDIZING THE USE OF PHQ-9 IN PRIMARY CARE SETTINGS. MEMORIAL INTEGRATING BEHAVIORAL HEALTH IN PRIMARY CARE BY INCREASING ACCESS TO PROVIDERS WITH PRESCRIBING ABILITY FOR OUTPATIENT NEEDS AND WORKING TO PROVIDE WARM AND EFFECTIVE HAND-OFF PROCESSES FOR PATIENTS WITH NEEDS. ACCESS TO BEHAVIORAL HEALTH INPATIENT CARE IS AN IMPORTANT COMPONENT OF IMPROVING THE OUTCOME FOR PATIENTS AND MEMORIAL IS PARTNERING WITH MULTICARE SYSTEM RESOURCES TO EVALUATE OPPORTUNITIES TO EXPAND CAPACITY AND EVALUATE POTENTIAL FOR SINGLE BED CERTIFICATION. MEMORIAL WILL CONTINUE TO EVALUATE ADDITIONAL OPPORTUNITIES FOR MODELS OF CARE AND OPPORTUNITIES TO PARTNER FOR PATIENTS WITH BEHAVIORAL HEALTH NEEDS.SUMMARYIN 2024, MEMORIAL MADE SIGNIFICANT STRIDES IN ADDRESSING THE TOP THREE PRIORITIES CALLED OUT AND LISTED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT: ACCESS TO HEALTH CARE, HEALTH EQUITY, AND BEHAVIORAL HEALTH. IN 2024 MEMORIAL FOCUSED ON STABILIZING ITS WORKFORCE AND IMPROVING ACCESS TO VARIOUS HEALTH SERVICES, INCLUDING PREVENTATIVE CARE, DIAGNOSTICS, AND TREATMENT, THROUGH PARTNERSHIPS WITH LOCAL EDUCATIONAL INSTITUTIONS AND THE IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS. THE OPENING OF INDIGO URGENT CARE AND MULTICARE OCCUPATIONAL MEDICINE CLINIC, ALONG WITH THE EXPANSION OF INPATIENT CAPACITY, SIGNIFIED THE COMMITMENT TO MEET THE RISING DEMAND. EFFORTS TO INCREASE HEALTH EQUITY INVOLVED EXPANDING TRAINING IN CULTURAL COMPETENCY AND HEALTH EQUITY, ALONGSIDE ENHANCING WORKFORCE REPRESENTATION FROM DIVERSE BACKGROUNDS. BEHAVIORAL HEALTH INITIATIVES INCLUDED INTEGRATING BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE, INCREASING ACCESS TO OUTPATIENT PROVIDERS, AND EVALUATING OPPORTUNITIES TO EXPAND INPATIENT BEHAVIORAL HEALTH CARE. THESE COMPREHENSIVE EFFORTS DEMONSTRATED MEMORIAL'S DEDICATION TO IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY. YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 13H: FULL OR PARTIAL DISCOUNTS MAY BE PROVIDED TOPATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FINANCIAL ASSISTANCE. SUCHDISCOUNTS MAY BE PROVIDED TO PATIENTS WITH CATASTROPHIC COSTS ORCONDITIONS WHEN CIRCUMSTANCES AS DETERMINED BY YVMH INDICATE THAT FULLPAYMENT MAY CAUSE EXTRAORDINARY FINANCIAL HARDSHIP TO THE PATIENT OR THEPATIENT'S FAMILY. YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16J: THE POLICY IS POSTED ON THE WA STATE - DEPARTMENT OF HEALTH WEBSITE. THE HOSPITAL'S BILLING INVOICES INCLUDE REFERENCES TO WHERE AND HOW TO CONTACT SOMEONE TO OBTAIN A COPY OF THE FINANCIAL ASSISTANCE POLICY.LINE 16 - SUPPLEMENTAL INFORMATION:YAKIMA VALLEY MEMORIAL HOSPITAL THROUGH MULTICARE HEALTH SYSTEM (ITS' PARENT CORPORATION) HAS TRANSLATED ITS FA POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY INTO THE PRIMARY LANGUAGES SPOKEN BY LIMITED ENGLISH PROFICIENCY POPULATIONS. PART V, SECTION B, LINE 3E THE SIGNIFICANT NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. 24 1 - NORTH STAR LODGE 808 N 39TH AVENUE YAKIMA WA 98902 CANCER TREATMENT CENTER 2 - VALLEY IMAGING 314 S 11TH AVENUE YAKIMA WA 98902 RADIOLOGY 3 - YAKIMA VALLEY HOME HEALTH 302 S 10TH AVENUE YAKIMA WA 98902 HOME HEALTH AND HOSPICE 4 - PHYSICIANS ANESTHESIA 406 S 30TH AVE STE 202 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 5 - YAKIMA MEMORIAL HEARTLUNG &VASCULAR CTR 406 S 30TH AVENUE SUITE 101 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 6 - OHANA 1515 W YAKIMA AVENUE YAKIMA WA 98902 MAMMOGRAPHY 7 - RIDGEVIEW SURGERY 2500 RACQUET LANE STE 150 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 8 - MEMORIAL PHYSICIANS LAB 4003 CREEKSIDE LOOP YAKIMA WA 98902 MEDICAL LABORATORY 9 - GENERATIONS OBGYN 3003 TIETON DRIVE STE 230 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 10 - PAIN CENTER - WATER'S EDGE 1460 N 16TH AVENUE SUITE D YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 11 - YAKIMA UROLOGY ASSOC AT MEMORIAL TRU 2500 RACQUT LANE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 12 - LAKEVIEW SPINE 1470 N 16TH AVENUE YAKIMA WA 98902 THERAPY 13 - YAKIMA GASTROENTEROLOGY ASSOCIATES 3909 CREEKSIDE LOOP SUITE 120 YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 14 - FAMILY MEDICINE OF YAKIMA 504 N 40TH AVENUE YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 15 - YAKIMA EAR NOSE AND THROAT 1601 CREEKSIDE LOOP YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 16 - CASCADE SURGICAL PARTNERS 3003 TIETON DRIVE STE 300 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 17 - MEMORIAL SLEEP SPECIALISTS 406 S 30TH AVE SUITE 206 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 18 - MEMORIAL CORNERSTONE MEDICINE 4003 CREEKSIDE LOOP YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 19 - PACIFIC CREST FAMILY MEDICINE 311 S 72ND AVENUE YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC 20 - APPLE VALLEY FAMILY MEDICINE 1008 S 38TH AVENUE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 21 - SELAH FAMILY MEDICINE 620 N PARK DRIVE SELAH WA 98942 OUTPATIENT PHYSICIAN CLINIC 22 - YAKIMA GASTROENTEROLOGY ASSOCIATES 3909 CREEKSIDE LOOP STE 115 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 23 - CARDIAC REHAB AND WELLNESS CENTER 406 S 30TH AVE STE 208 YAKIMA WA 98902 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC 24 - HEART LUNG AND VASCULAR 406 S 30TH AVE STE 101 YAKIMA WA 98902 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATIONALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'SSPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY,INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. PART I, LINE 7: THE AMOUNTS ARE CALCULATED BASED ON A COST-TO-CHARGE RATIO WHICH WAS CALCULATED BASED ON WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: NONE OF THE SUBSIDIZED HEALTH SERVICES INCLUDE COSTS ASSOCIATED WITH PHYSICIAN CLINICS. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBTS THAT WERE EXCLUDED FROM THE TOTAL EXPENSES WHEN CALCULATING THE PERCENTAGE IN COLUMN (F) WAS $2,807,790.PART III, SECTION A, LINE 2, COSTING METHODOLOGY:THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.3-4. PART III, SECTION A, LINE 3, RATIONALE FOR BAD DEBT AMOUNT ATTRIBUTABLE TO COMMUNITY BENEFIT: THE METHODOLOGY USED BY THE ORGANIZATION TO ESTIMATE THIS AMOUNT SINCE THIS IS ZERO, THE ORGANIZATION BELIEVES THE FAP PROCEDURES AND PRESUMPTIVE ELIGIBILITY TO BE SUFFICIENT AND NO INDIVIDUALS ELIGIBLE UNDER THE FAP ARE INCLUDED IN BAD DEBT. PART II, COMMUNITY BUILDING ACTIVITIES: YAKIMA VALLEY MEMORIAL ACTIVELY PARTICIPATES IN NUMEROUS COMMUNITY BUILDING ACTIVITIES. THEIR EMPLOYEES VOLUNTEER IN VARIOUS PROGRAMS SUCH AS THE AMERICAN RED CROSS, UNITED WAY, AMERICAN HEART ASSOCIATION, COMMUNITIES IN SCHOOLS, HABITAT FOR HUMANITY, SAFE STREETS COALITION, YWCA (PROVIDING A DOMESTIC VIOLENCE SHELTER FOR WOMEN AND CHILDREN), AMERICAN CANCER SOCIETY, AND OTHER ORGANIZATIONS.THE FOLLOWING ACTIVITIES AVAILABLE TO ALL COMMUNITY MEMBERS PROVIDE OPPORTUNITIES FOR IMPROVED PHYSICAL, MENTAL, AND EMOTIONAL HEALTH:YOUTHWORKS INITIATIVE;ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS. PART III, LINE 8: COSTING METHODOLOGY:THE SOURCE USED TO CALCULATE THE MEDICARE ALLOWABLE COSTS FOR YAKIMA VALLEY MEMORIAL HOSPITAL WAS THE 2024 MEDICARE COST REPORT.THE COST TO CHARGE RATIO, AS CALCULATED FROM THE INCOME STATEMENT, WAS APPLIED TO THE PS&R GROSS MEDICARE CHARGES TO CALCULATE THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6. MEDICARE SHORTFALL TREATED AS COMMUNITY BENEFIT:THE HOSPITAL BELIEVES THAT ALL OF THE $7.7 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B: YAKIMA VALLEY MEMORIAL HOSPITAL IS SUBJECT TO THE MHS POLICY.MULTICARE'S DEBT COLLECTION POLICY STATES THAT "MHS WILL ALSO CLEARLY COMMUNICATE TO PATIENTS AND APPLICABLE PARTIES THE VARIOUS ASSISTANCE PROGRAMS MHS OFFERS BASED ON THE SITE OF SERVICE." IF THE PATIENT FOLLOWS THROUGH WITH THE APPLICABLE ASSISTANCE APPOINTMENTS, I.E., MEETING WITH MEDICAID OR COUNTY AGENCIES TO COMPLETE THE NECESSARY APPLICATION PROCESS, MULTICARE WILL NOT SEND THE ACCOUNT TO A BAD DEBT COLLECTION AGENCY.THERE ARE CIRCUMSTANCES WHERE A PATIENT DOES NOT RESPOND TO MULTICARE'S BILLING STATEMENTS AND IS SENT TO COLLECTIONS. AT THIS POINT, WHEN THEY ARE IN COLLECTIONS, IF THEY REQUEST FINANCIAL ASSISTANCE AND MEET CRITERIA UNDER THE FINANCIAL ASSISTANCE POLICY'S FEDERAL POVERTY GUIDELINES (FPG), THE COLLECTIONS WILL NOT BE PURSUED. PART VI, LINE 2: YAKIMA VALLEY MEMORIAL HOSPITAL COLLABORATES WITH REGIONAL AGENCIES AND ORGANIZATIONS TO IDENTIFY THE HEALTHCARE REQUIREMENTS OF THE COMMUNITY IT SERVES AND TO ESTABLISH PROGRAMS AND SERVICES THAT ADDRESS THOSE NEEDS.YAKIMA VALLEY MEMORIAL PARTNERS WITH VARIOUS COMMUNITY ENTITIES, SUCH AS PUBLIC HEALTH AGENCIES, UNITED WAY AGENCIES, CITY MUNICIPALS, PUBLIC SCHOOLS, COMMUNITY COALITIONS, FEDERALLY QUALIFIED HEALTH CENTERS, YMCA'S, AND OTHERS.TO DETERMINE THE MOST CRITICAL HEALTHCARE NEEDS IN ITS SERVICE AREAS, YAKIMA MEMORIAL HOSPITAL UTILIZES DATA FROM ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENT (CHA), AND FEDERAL AND STATE-LEVEL DATA.GIVEN THE COMPREHENSIVENESS OF THE CHNA PROCESS, THE ORGANIZATION DOES NOT CONDUCT ADDITIONAL ASSESSMENTS.FOR MORE DETAILED INFORMATION, SEE PART V, SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION B. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN A VARIETY OF WAYS. FINANCIAL AID INFORMATION IS POSTED ON THE MULTICARE.ORG EXTERNAL WEBSITE.PRE-SERVICE CENTER STAFF STARTS CONVERSATIONS WITH PATIENTS ABOUT THEIR POTENTIAL FINANCIAL RESPONSIBILITY AND SHARE PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE INFORMATION WITH THE PATIENT DURING THIS INITIAL PHONE CALL. AT THE TIME OF REGISTRATION (WHETHER PRE-REGISTERED OR NOT), PATIENTS ARE NOTIFIED ABOUT THEIR INSURANCE COVERAGE AND FINANCIAL LIABILITIES. FINANCIAL COUNSELORS ARE AVAILABLE IF A NEED IS IDENTIFIED. PART VI, LINE 4: YAKIMA COUNTY IS COMPOSED OF PRIMARILY RURAL COMMUNITIES (14 CITIES ANDTOWNS) IN CENTRAL WASHINGTON, SPANNING 4,300 SQUARE MILES. TOTAL CURRENTPOPULATION FOR YAKIMA COUNTY AS OF 2022 IS 257,805. THE POPULATION DENSITYFOR THIS AREA, ESTIMATED AT 56.6 PERSONS PER SQUARE MILE, IS LESS THAN THENATIONAL AVERAGE POPULATION DENSITY OF 93.8 PERSONS PER SQUARE MILE. THEPRIMARY SERVICE AREA (PSA) OF YAKIMA VALLEY MEMORIAL HOSPITAL IS COMPRISEDOF YAKIMA COUNTY. SECONDARY SERVICE AREAS (SSA) FOR HIGHLY SPECIALIZED PROGRAMS AND SERVICES (E.G. CHILDREN'S VILLAGE) STRETCHES INTO NEIGHBORING COUNTIES INCLUDING KITTITAS AND KLICKITAT. LOCATED WITHIN YAKIMA COUNTY IS THE YAKAMA NATION RESERVATION WHICH IS OVER 1.3 MILLION ACRES AND REACHESACROSS THE CASCADES. THE PERCENTAGE OF THE POPULATION IN YAKIMA COUNTYTHAT IS FOREIGN BORN (18.4%) EXCEEDS BOTH THE WASHINGTON STATE (14.5%) ANDTHE U.S. PERCENTAGES (13.5%). ACUTE CARE HOSPITALS IN WASHINGTON CONSISTOF A 58.5% MEDICARE/MEDICAID PATIENT PAYOR MIX (38.2% MEDICARE AND 20.3% MEDICAID). ACCORDING TO THE WASHINGTON STATE DEPARTMENT OF SOCIAL ANDHEALTH SERVICES APPROXIMATELY 43% OF THE POPULATION IS RECEIVINGECONOMICAL SERVICES ASSISTANCE, PRIMARILY FOR: CHILD SUPPORT SERVICES,CHILDCARE, AND BASIC FOOD PROGRAMS. OUR COMMUNITY IS COMPRISED OF 52.3%PERSONS OF HISPANIC OR LATINO ORIGIN AND 42.3% OF PERSONS OF WHITENON-HISPANIC OR LATINO ORIGIN, AND 6.7% AMERICAN INDIAN AND ALASKA NATIVE.16.5% OF PERSONS LIVING AT POVERTY LEVEL, 5.9% ARE UNEMPLOYED, AND 12.2%UNINSURED. PART VI, LINE 5: MEMORIAL IS COMMITTED TO LEADING, FACILITATING, PARTNERING, AND PROMOTINGTHE HEALTH OF CENTRAL WASHINGTON. THE PROMOTION OF COMMUNITY HEALTH ISACCOMPLISHED THROUGH COLLABORATIONS, RESEARCH-BASED EDUCATION ANDINTERVENTIONS FOCUSED ON DISPARITY ELIMINATION AND ADDRESSING SOCIALDETERMINANTS OF HEALTH. SURPLUS FUNDING IS USED TO PROVIDE OVERSIGHT,PROGRAM PLANNING AND EVALUATION; AS WELL AS DIRECT CARE TO CHILDREN WITHSPECIAL HEALTH CARE NEEDS THROUGH CHILDREN'S VILLAGE, AND PROMOTION OFWELL-BEING THROUGH EVIDENCE-BASED COMMUNITY HEALTH PROGRAMMING. THISINCLUDES CHRONIC HEALTH ISSUES AND OTHER RISK FACTORS THAT CONTRIBUTE TOPOOR HEALTH OUTCOMES. MEMORIAL HAS DEDICATED STAFF, CONTRACTORS, AND FTEPOSITIONS TO ACCOMPLISH THE DEVELOPMENT, PLANNING AND INTERVENTIONS TOADDRESS COMMUNITY NEEDS. MEMORIAL BUDGETS SURPLUS FUNDS TO ALLOWCONTINUING SUPPORT OF EDUCATION THROUGH PARTNERSHIPS WITH PACIFICNORTHWEST UNIVERSITY, CENTRAL WASHINGTON FAMILY PRACTICE RESIDENCY,OBSTETRICAL EDUCATION AND ENSURING MEMORIAL HAS THE STAFF TO SUPPORT OURCOMMUNITIES' EDUCATION NEEDS. FUNDS ARE ALSO USED TO ENSURE THAT WE HAVETHE FACILITIES AND EQUIPMENT TO MEET THE GREATEST NEEDS OF THE COMMUNITY.EXAMPLES INCLUDE: HEALTHY NOW CLINICS, EXPANDING THE INPATIENT PSYCHIATRIC DEPARTMENT AND COTTAGE IN THE MEADOW FOR END OF LIFE CARE.TO MEET THE ACCESS NEEDS OF THE COMMUNITY MEMORIAL EXTENDS MEDICAL STAFFPRIVILEGES TO ALL QUALIFIED PHYSICIANS WITHIN THE COMMUNITY WHO APPLY TOITS MEDICAL STAFF, AND ALLIED HEALTH STAFF AND WHO MEET QUALIFICATIONS SETFORTH IN THE MEDICAL STAFF'S BYLAWS, RULES AND REGULATIONS, POLICIES ANDSPECIFIC DEPARTMENTAL PRIVILEGING DOCUMENTS. FOR THE MOST CRITICALSHORTAGES, PARTICULARLY WITHIN SPECIALTY AREAS MEMORIAL EXTENDS THEPRIVILEGES TO PHYSICIANS OUTSIDE OF THE COMMUNITY TO MEET THE NEED.THE MAJORITY OF MEMORIAL'S GOVERNING BODY CONSISTS OF PERSONS WHO RESIDEWITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL: YAKIMA COUNTY; NO MEMBERSOF THE GOVERNING BODY ARE CONSIDERED EMPLOYEES OR INDEPENDENT CONTRACTORS. PART VI, LINE 6: YAKIMA VALLEY MEMORIAL HOSPITAL IS A PIVOTAL HOSPITAL SERVING CENTRAL WASHINGTON AND IS PART OF THE MULTICARE HEALTH SYSTEM ("MULTICARE") SINCE 2023. MULTICARE IS A WASHINGTON NOT-FOR-PROFIT CORPORATION, ORGANIZED AS A TAX-EXEMPT ENTITY UNDER IRC SECTION 501 (C)(3). MULTICARE HAS APPROXIMATELY 25,000 TEAM MEMBERS, INCLUDING EMPLOYEES, PROVIDERS AND VOLUNTEERS. MULTICARE'S ROOTS IN THE PACIFIC NORTHWEST GO BACK TO 1882, WITH THE FOUNDING OF TACOMA'S FIRST HOSPITAL. OVER THE YEARS, MULTICARE HAS GROWN FROM A TACOMA-CENTRIC, HOSPITAL-BASED ORGANIZATION INTO THE LARGEST, COMMUNITY-BASED, LOCALLY GOVERNED HEALTH SYSTEM IN THE STATE OF WASHINGTON.TODAY, ITS' COMPREHENSIVE SYSTEM OF HEALTH INCLUDES MORE THAN 700 PRIMARY, URGENT, PEDIATRIC AND SPECIALTY CARE LOCATIONS ACROSS WASHINGTON, IDAHO AND OREGON, AS WELL AS 13 HOSPITALS, THREE FOUNDATIONS AND SEVERAL AFFILIATES. MULTICARE'S COMPREHENSIVE SYSTEM OF HEALTH INCLUDES PRIMARY CARE, URGENT CARE AND SPECIALTY SERVICES - INCLUDING MULTICARE INDIGO URGENT CARE, MULTICARE ROCKWOOD CLINIC, AND YAKIMA VALLEY MEMORIAL'S MULTIPLE CLINICS LOCATIONS, MAKING MULTICARE THE LARGEST MULTISPECIALTY CLINIC SYSTEM IN THE INLAND AND CENTRAL NORTHWEST REGION. SPECIALTY SERVICES INCLUDE LEVEL II ADULT AND PEDIATRIC TRAUMA CENTER, LEVEL IV NEONATAL INTENSIVE CARE UNIT, THE REGION'S ONLY LEVEL I TRAUMA REHABILITATION CENTER AND AN INTERNATIONALLY RENOWNED THERAPY UNIT FOR CHILDREN WITH SPECIAL NEEDS. MULTICARE ALSO INCLUDES HIGHLY SPECIALIZED AFFILIATED ENTITIES, SUCH AS CHVI PULSE HEART INSTITUTE, SPECIALIZED IN THE TREATMENT AND RESEARCH OF THE HEART, AND MULTICARE REHABILITATION SPECIALISTS P.C. AND OLYMPIC SPORTS AND SPINE, LLC, ENTITIES FOCUSED FOR DELIVERING ACCESSIBLE AND AFFORDABLE PHYSICAL AND REHABILITATION THERAPY SERVICES, INDIGO IDAHO LLC, TO SERVE NORTHEN IDAHO'S GWROWING POPULATION. IN 2022 MULTICARE EXPANDED IN IDAHO AND OREGON WITH THE CREATION OF INDIGO IDAHO, LLC A PARTNERSHIP WITH KOOTENAI HEALTHCARE SYSTEM AND TWO CHVI-PULSE CLINICS IN OREGON. THROUGH ITS AFFILIATIONS WITH NAVOS (2017) AND GREATER LAKES MENTAL HEALTHCARE (2018) MULTICARE IS THE LARGEST BEHAVIORAL HEALTH PROVIDER IN WASHINGTON STATE. IN 2019 MULTICARE HEALTH SYSTEM IN PARTNERSHIP WITH CHI FRANCISCAN HEALTH OPENED WELLFOUND BEHAVIORAL HEALTH HOSPITAL, A NOT-FOR-PROFIT MENTAL HEALTH HOSPITAL IN TACOMA, WASHINGTON, FURTHER ADDRESSING THE NEED FOR MENTAL HEALTH AND WELLBEING IN THE COMMUNITY. SINCE THEN, WELLFOUND HAS CREATED AN IMPLEMENTATION STRATEGY TO ADDRESS ITS COMMUNITY IN THE AREAS OF ACCESS TO CARE, SUICIDE, DRUG AND ALCOHOL USE, AND DEPRESSION. MULTICARE'S AFFILIATION WITH THESE ORGANIZATIONS ALLOWS TO BETTER PROVIDE ESSENTIAL BEHAVIORAL HEALTH SERVICES AND CONNECT OUR PATIENTS TO ESSENTIAL COMMUNITY RESOURCES. MULTICARE HEALTH SYSTEM'S NETWORK OF CARE INCLUDES 13 HOSPITALS SUCH AS: MULTICARE TACOMA GENERAL AND ALLENMORE HOSPITAL IN TACOMA, MULTICARE AUBURN AND COVINGTON MEDICAL CENTERS IN SOUTH KING COUNTY, MULTICARE GOOD SAMARITAN HOSPITAL IN PUYALLUP, MULTICARE CAPITAL MEDICAL CENTER IN OLYMPIA, MULTICARE DEACONESS AND VALLEY HOSPITALS IN SPOKANE AND SPOKANE VALLEY, MARY BRIDGE CHILDREN'S HOSPITAL SPECIALIZED IN CHILDREN'S CARE, NAVOS IN SEATTLE AND WELLFOUND IN TACOMA ARE HOSPITALS SPECIALIZED IN BEHAVIORAL HEALTH AND NOT THE LAST BUT THE LATEST AFFILIATIONS, MULTICARE YAKIMA VALLEY MEMORIAL HOSPITAL,OVERLAKE HOSPITAL MEDICAL CENTER. IN 2023 MULTICARE AFFILIATED WITH YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION SERVING THIS WAY CENTRAL WASHINGTON'S YAKIMA VALLEY. MULTICARE YAKIMA MEMORIAL IS A 238-BED ACUTE-CARE, NOT-FOR-PROFIT HOSPITAL THAT HAS SERVED CENTRAL WASHINGTON'S YAKIMA VALLEY SINCE 1950. THE MEMORIAL FOUNDATION IS THE FUNDRAISING DIVISION OF THE YAKIMA VALLEY HEALTH SYSTEM AND NOW ALSO AFFILIATED WITH THE MULTICARE HEALTH SYSTEM.IN 2024 MULTICARE WELCOMED OVERLAKE MEDICAL CENTER & CLINICS TO THE MULTICARE FAMILY. OVERLAKE MEDICAL CENTER & CLINICS IS A NONPROFIT HEALTHCARE SYSTEM BASED IN BELLEVUE, WASHINGTON, SERVING THE COMMUNITY SINCE 1960.THE 2023 AND 2024 AFFILIATIONS ARE AN EXCEPTIONAL MILESTONE FOR THE MULTICARE ORGANIZATION WHO IS LOOKING TO BECOME THE PACIFIC NORTHWEST'S HIGHEST VALUE SYSTEM OF HEALTH.WITHOUT A DOUBT, MULTICARE AS AN ORGANIZATION HAS CHANGED OVER THE YEARS BUT WHAT HAS NEVER CHANGED, THROUGHOUT ITS' LONG HISTORY, IT HAS BEEN ITS' DEDICATION TO HEALTH AND WELLNESS OF THE PEOPLE OF THE PACIFIC NORTHWEST. GUIDED BY ITS' MISSION, VISION, AND VALUES, MULTICARE IS ON CONTINUOUS JOURNEY TO DELIVER THE SERVICES THAT ITS' COMMUNITIES NEED, AND TO ENSURE ACCESS TO THOSE SERVICES, NOW AND IN THE FUTURE.MULTICARE'S AFFILIATION WITH THESE ORGANIZATIONS ALLOWS TO BETTER PROVIDE ESSENTIAL COMPREHENSIVE HEALTH SERVICES AND CONNECT WITH ITS' PATIENTS TO ESSENTIAL COMMUNITY RESOURCES. PART VI, LINE 7, REPORTS FILED WITH STATES WA 1 THE MEMORIAL FOUNDATION 3111 TIETON DRIVE YAKIMA WA 98902 911022358 501(C)(3) 951983 0 GENERAL ASSISTANCE 1 PART I, LINE 2: YAKIMA VALLEY MEMORIAL HOSPITAL IS SUBJECT TO THE MULTICARE HEALTH SYSTEM POLICY. YAKIMA VALLEY MEMORIAL HOSPITAL PROVIDES FUNDING TO MEMORIAL FOUNDATION. THE MEMORIAL FOUNDATION IS A RELATED 501(C)(3) ORGANIZATION, SUPPORTING THE YAKIMA COUNTY AND SUPPORTING YAKIMA VALLEY MEMORIAL HOSPITAL. THE MONITORING HAPPENS BY SEEING THE BENEFITS OF THE ORGANIZATION IN THE COMMUNITY AND SEEING THE FUNDING COMING BACK THROUGH CONTRIBUTIONS TO PROGRAMS AND SERVICES AT MULTICARE YAKIMA MEMORIAL HOSPITAL. 0 0 0 0 0 0 0 0 0 LUCAS FAYEZ BAZI PHYSICIAN 1096229 0 80000 0 781 0 20626 0 24529 0 1222165 0 0 0 SAURABH RANJAN PHYSICIAN 1037677 0 80000 0 1091 0 19613 0 7439 0 1145820 0 0 0 SIVA MANNEM PHYSICIAN 923740 0 0 0 682 0 22553 0 24632 0 971607 0 0 0 JEFFREY BUSHMAN PHYSICIAN 863679 0 23333 0 647 0 22727 0 24632 0 935018 0 0 0 HARMANJOT GILL PHYSICIAN 834475 0 20000 0 439 0 15673 0 24632 0 895219 0 0 0 TAMMY BUYOK PRESIDENT & YAKIMA MARKET LEADER 0 458744 0 112994 0 55150 0 20700 0 17899 0 665487 0 0 NATHANIEL DAVENPORT CHIEF MEDICAL OFFICER 395988 0 32541 0 3679 0 42291 0 27007 0 501506 0 0 0 KIMBERLY BERSING COO & CHIEF NURSING EXECUTIVE 253050 0 46347 0 30791 0 25601 0 16542 0 372331 0 0 0 SCOTT JONES CHIEF OPERATIONS OFFICER 292172 0 32828 0 24450 0 2796 0 17883 0 370129 0 0 0 MAXWELL OWENS CFO 152705 0 0 0 12949 0 0 0 4146 0 169800 0 0 0 SCHEDULE J, PART I, LINE 3: YAKIMA VALLEY MEMORIAL HOSPITAL RELIED ON A RELATED ORGANIZATION, MULTICARE HEALTH SYSTEM, TO ESTABLISH THE COMPENSATION FOR THE ORGANIZATION'S PRESIDENT. SEE SCHEDULE O, PART VI, LINE 15 NARRATIVE FOR PROCESS USED BY MULTICARE HEALTH SYSTEM. JORGE GARCIA FAMILY MEMBER OF CYNTHIA JUAREZ 127368 EMPLOYMENT 0 BREAN GARCIA FAMILY MEMBER OF CYNTHIA JUAREZ 116281 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 4 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION MADE SIGNIFICANT CHANGES TO ITS GOVERNING DOCUMENTS AS FOLLOWS: THE ORGANIZING DOCUMENTS WERE UPDATED TO LIST MULTICARE HEALTH SYSTEM, (MHS), A 501(C)(3) TAX EXEMPT ORGANIZATION, AS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS THE SOLE CORPORATE MEMBER IS MULTICARE HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION. MULTICARE SHALL ACT THROUGH ITS CHIEF EXECUTIVE OFFICER OR DESIGNEE AS YAKIMA VALLEY MEMORIAL HOSPITAL'S SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE CHIEF EXECUTIVE OFFICER OR DESIGNEE OF MULTICARE HEALTH SYSTEM, AS THE SOLE CORPORATE MEMBER, HAS THE POWER TO APPOINT OR REMOVE ANY ELECTED DIRECTOR ON THE BOARD OF DIRECTORS OF YAKIMA VALLEY MEMORIAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REQUIRING APPROVAL THE DECISIONS THAT REQUIRE THE SOLE CORPORATE MEMBER MULTICARE HEALTH SYSTEM APPROVAL ARE: APPOINTMENT AND REMOVAL OF ELECTED DIRECTORS; ANNUAL CAPITAL AND OPERATING BUDGETS, INCLUDING COMPENSATION PLANS; STRATEGIC PLANS; SELECTION AND APPOINTMENT OF THE PRESIDENT OF YAKIMA VALLEY MEMORIAL HOSPITAL; INCURRENCE OF INDEBTEDNESS; SALE OR DISPOSITION OF REAL PROPERTY; ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS; AND MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS. ALL OTHER DECISIONS ARE MADE BY THE YAKIMA VALLEY MEMORIAL HOSPITAL DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 THE YAKIMA VALLEY MEMORIAL HOSPITAL TAX FORM 990 IS PREPARED BY INTERNAL STAFF AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM. INITIAL REVIEWS ARE PERFORMED BY LEVELS OF MANAGEMENT IN VARIOUS DEPARTMENTS THROUGHOUT THE ORGANIZATION, INCLUDING THE YAKIMA VALLEY MEMORIAL HOSPITAL PRESIDENT. A REVIEW WAS THEN PERFORMED BY THE BOARD OF DIRECTORS. ADDITIONALLY, A REVIEW WAS PERFORMED BY THE AUDIT COMMITTEE OF THE MULTICARE HEALTH SYSTEM BOARD, AND INCLUDED A PRESENTATION BY THE OUTSIDE ACCOUNTING FIRM. LASTLY, A COPY OF THE FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, WAS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS USED TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY AND D) UNDERSTANDS THAT THE CORPORATION IS A TAX EXEMPT ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE BOARD IS RESPONSIBLE FOR MAKING SURE PERIODIC REVIEWS OF THE STATEMENTS ARE DONE AND MAY USE OUTSIDE ADVISORS. IF A CONFLICT OF INTEREST ARISES, THE INTERESTED PERSON MAY PRESENT TO THE BOARD, BUT MUST LEAVE DURING THE DISCUSSION OF AND VOTE ON THE CONFLICT OF ISSUE TRANSACTION OR ARRANGEMENT. A DISINTERESTED PERSON OR COMMITTEE IS APPOINTED TO INVESTIGATE ALTERNATIVES AND THE BOARD MUST EXERCISE DUE DILIGENCE TO DETERMINE IF THE ORGANIZATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT. REGARDING COMPENSATION, A VOTING MEMBER OF THE BOARD WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION FOR SERVICES IS PRECLUDED FROM VOTING ON COMPENSATION MATTERS. APPROPRIATE DISCIPLINARY AND CORRECTION ACTION MAY BE TAKEN AGAINST INTERESTED PERSONS WHO FAIL TO DISCLOSE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S PRESIDENT IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. THE PROCESS USED TO DETERMINE COMPENSATION OF THE PRESIDENT IS PERFORMED BY THE RELATED ORGANIZATION AS FOLLOWS: THE BOARD, THROUGH ITS COMPENSATION COMMITTEE, CONSISTING OF INDEPENDENT,NON-PAID, BOARD MEMBERS OF THE RELATED ORGANIZATION, ARE ACCOUNTABLE FOR ENSURING AND APPROVING A REASONABLE TOTAL COMPENSATION PACKAGE, CONSISTENT WITH ITS COMPENSATION PHILOSOPHY, FOR THE CEO, CFO, TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES FOR THEIR MANAGEMENT AND LEADERSHIP OF RELATED ENTITIES. UPON THE IDENTIFICATION OF THE COMPENSATION FOR THE YEAR, THE INDEPENDENT CONSULTANT SULLIVAN COTTER, REVIEWS THE COMPENSATION AS PROPOSED BY THE BOARD OF DIRECTORS, AND CONDUCTS AN INDEPENDENT REVIEW. AT THE CONCLUSION OF THIS REVIEW, SULLIVAN COTTER ISSUES A REASONABLENESS OPINION TO THE RELATED ORGANIZATION. THIS IS DONE ANNUALLY AND WAS DONE FOR THE CURRENT YEAR. THE INDEPENDENT CONSULTANTS ASSESSED THAT THE COMPENSATION APPROVED BY THE BOARD FOR 2024 WAS OBJECTIVELY REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO INCLUDED AS PART OF THE FORM 990. FORM 990, PART XI, LINE 9: CHANGES IN PENSION ASSET -4,753,691. TRANSFER OF ASSETS YVMH & SIGNAL HEALTH -4,519,533. ROUNDING 92. 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