2026-05-15T09:10:22-05:00 2025-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2024-07-01 910564491 COMMONSPIRIT WASHINGTON F/K/A FRANCISCAN HEALTH SYSTEM COMM 2536804005 3033 N 3RD AVE PHOENIX AZ 85013 DAVID NOSACKA CFO 2536804005 2026-05-15 1 0 PAMELA KROHN P01210500 3032989100 2024 2025-03-06 01:10:19Z X X FRANCISCAN HEALTH SYSTEM JULIE MANAS 3033 N 3RD AVE PHOENIX AZ 85013 1991111655 0 0928 X WWW.VMFH.ORG X 1891 WA FHS WAS FOUNDED ON THE PRINCIPLE TO PROVIDE COMPASSIONATE CARE TO EVERYONE REGARDLESS OF ABILITY TO PAY OR SOCIAL STATUS. FHS INCLUDES MULTIPLE FACILITIES AND HOSPICE, AND AN EXPANDING NETWORK OF CLINICS. 17 16 9043 259 13173585 1205456 25679893 37293785 1719329495 1890017569 30299183 1739618 46143467 62060683 1821452038 1991111655 1198351 2322220 0 0 791565865 886530662 0 0 0 1089533644 1112816333 1882297860 2001669215 -60845822 -10557560 1170404055 1147131491 757366370 945965682 413037685 201165809 AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 1744263600 2322220 1890017569 SEE SCHEDULE H 1744263600 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 X 0 0 9043 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 17 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 1 0 X DAVID NOSACKA 2536804000 1717 SOUTH J STREET TACOMA WA 98405 KETUL PATEL CEO VMFH & PRESIDENT NORTHWEST REGION 2.00 58.00 X 0 5665901 88958 CHARLEEN TACHIBANA RN REGION CHIEF QUALITY-SAFETY-PATIENT EXP OFFICER-NW 60.00 0.00 X 1578856 0 32392 JAMES TERWILLIGER PRESIDENT, PUGET SOUND MARKET (THRU 02/25) 60.00 0.00 X 1390307 0 96214 THOMAS KRUSE REGION CHIEF STRATEGY OFFICER-NW 60.00 0.00 X 1029204 0 41047 DAVID NOSACKA TREASURER/SVP&CFO NORTHWEST REGION 58.00 2.00 X 872310 0 61972 RUSSELL WOOLLEY FORMER COO ST FRANCIS & ST ANNE HOSPITALS 0.00 60.00 X 0 708857 102943 RYAN PONG REGION VP ACADEMIC OFFICER NW 60.00 0.00 X 754346 0 56898 DIANNE AROH REGION CHIEF NURSING OFFICER-NW (THRU 2/25) 60.00 0.00 X 765892 0 23414 KIMBERLY MOORE VP/INTERIM CHIEF MEDICAL OFFICER (THRU 05/24) 60.00 0.00 X 733218 0 33947 HANS CASSAGNOL CHIEF MEDICAL OFFICER NW 60.00 0.00 X 716057 0 22916 INGRID GERBINO CHIEF INNOVATION OFFICER 60.00 0.00 X 661670 0 33645 TOBY SUTTON REGION CHRO-NW 60.00 0.00 X 596389 0 19328 DAVID WEISS FORMER MKT VP MEDICAL OPERATIONS 60.00 0.00 X 559209 0 41048 DAVID BUTCHERITE FORMER TREASURER/REGION VP FINANCE NW 60.00 0.00 X 460998 0 41857 MIRIAM CHAMBLISS CORPORATE SECRETARY/VP GENERAL COUNSEL NORTHWEST R 2.00 58.00 X 0 428659 45640 SHARON ROYNE FORMER KE/VP ADMINISTRATIVE SERVICES 60.00 0.00 X 406549 0 38829 MATTHEW METSKER PA-C MPAS MHA CMPE PRESIDENT ST CLARE HOSPITAL 60.00 0.00 X 387155 0 50863 MICHAEL COX FORMER KEY EMPLOYEE/CHIEF MISSION OFFICER 60.00 0.00 X 380900 0 56192 DINO JOHNSON PRESIDENT ST ANTHONY HOSPITAL 60.00 0.00 X 373965 0 52668 DEEPAK DEVASTHALI PRESIDENT ST. JOSEPH MEDICAL CENTER 60.00 0.00 X 329588 0 54184 JENNIFER SCHOMBURG PRESIDENT ST JOSEPH MEDICAL CENTER (THRU 7/24) 60.00 0.00 X 303580 0 30454 SYDNEY BERSANTE FORMER INTERIM PRESIDENT SJMC 60.00 0.00 X 169231 0 12483 LOIS ERICKSON PRESIDENT ST CLARE HOSPITAL (THRU 5/24) 60.00 0.00 X 160956 0 19473 CHUCK ARNOLD DIRECTOR 2.00 6.00 X 0 0 0 LARRY BJORK DIRECTOR 2.00 6.00 X 0 0 0 BOB CARLILE DIRECTOR 2.00 6.00 X 0 0 0 ULI CHI PHD CHAIR 2.00 6.00 X X 0 0 0 JAMES CIVILLA DIRECTOR 2.00 6.00 X 0 0 0 CAROLYN CORVI DIRECTOR 2.00 6.00 X 0 0 0 SR RUTH GOODWIN OSF DIRECTOR 2.00 6.00 X 0 0 0 TOD HAMACHEK DIRECTOR 2.00 6.00 X 0 0 0 DAVID HOHIMER DIRECTOR 2.00 6.00 X 0 0 0 DENNIS HUNTHAUSEN DIRECTOR 2.00 6.00 X 0 0 0 KAREN LEE DIRECTOR 2.00 6.00 X 0 0 0 ROBERT LEMON VICE CHAIR 2.00 6.00 X X 0 0 0 SR ANNE MCNAMARA OSF DIRECTOR 2.00 6.00 X 0 0 0 GREGG MEYER MD MSC DIRECTOR 2.00 6.00 X 0 0 0 JOHN OPPENHEIMER DIRECTOR 2.00 6.00 X 0 0 0 DIANN PULS DIRECTOR 2.00 6.00 X 0 0 0 JAMES SMALLEY DIRECTOR 2.00 6.00 X 0 0 0 12630380 6803417 1057365 2756 1 1 0 MEDICAL SOLUTIONS LLC 1010 N 102ND ST SUITE 300 OMAHA NE 68114 TRAVEL NURSE SERVICES 88720587 DOCTORS CLINIC 9621 RIDGETOP BLVD NW SILVERDALE WA 98383 PROFESSIONAL SERVICES 36532998 SELLEN CONSTRUCTION COMPANY IN 227 WESTLAKE AVE SEATTLE WA 98109 CONSTRUCTION SERVICES 18242394 BALFOUR BEATTY CONSTRUCTION 19435 68TH AVE S S100 KENT WA 98032 CONSTRUCTION SERVICES 13638847 ALDRICH & ASSOCIATES INC 810 240TH ST SE BOTHELL WA 98021 CONSTRUCTION SERVICES 12310943 294 4740870 32532993 19922 37293785 NET PATIENT SERVICES 900099 1886555828 1886555828 0 0 RENTAL INCOME 900099 2754653 2754653 0 0 INTERCOMPANY TRANSACTI 900099 707088 707088 0 0 1890017569 1665401 1665401 1438579 0 1438579 1438579 1438579 30846 43371 0 0 30846 43371 74217 74217 PHARMACY SERVICES 446110 33555679 0 11633475 21922204 EMPLOYEE RETENTION CRE 900099 16624922 0 0 16624922 CAFETERIA 722100 5828142 0 0 5828142 4613361 1540110 3073251 60622104 1991111655 1890017569 13173585 50626716 X 2297445 2297445 24775 24775 6256263 483045 5773218 703058529 611287417 91771112 34254531 29472740 4781791 86459747 73852129 12607618 56501592 48026352 8475240 1796780 1706941 89839 6951 6603 348 210202 210202 408978608 335630494 73348114 9041241 8589179 452062 39632863 37651220 1981643 66375499 63056724 3318775 29037133 27585276 1451857 2057972 1234784 823188 763266 190816 572450 6871259 6871259 45047714 45047714 59987356 56987988 2999368 12546664 12546664 MEDICAL SUPPLIES 276363939 276363939 0 STATE PROVIDER TAX 80083747 80083747 0 OTHER TAXES 21918419 20822498 1095921 0 UNRELATED BUSINESS TAX 207175 0 207175 0 51889545 49491565 2397980 2001669215 1744263600 257405615 0 1396 0 0 0 0 0 403216179 411195955 0 0 0 0 0 0 45256062 45332302 4345555 2921553 1616347188 1150388630 478013715 465958558 0 0 720927 787757 0 0 16128395 16109861 222721826 204825505 1170404055 1147131491 416389008 729841789 0 0 584222 532294 0 0 0 0 0 0 0 0 0 0 340393140 215591599 757366370 945965682 X 412745185 200873309 292500 292500 413037685 201165809 1170404055 1147131491 X -10557560 26086 -201340402 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 210202 0 0 0 210202 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $34,833 CATHOLIC HEALTH ASSOCIATION - $16,997 ALLOCATED 340B LOBBYING-$1,075 WASHINGTON STATE HOSPITAL ASSOCIATION - $157,297 31803055 31803055 608706117 338809705 269896412 81936709 58131986 23804723 821747351 743135747 78611604 72153956 10311192 61842764 465958558 INVESTMENTS IN UNCONSOLIDATED ORGS - CONTROLLING INTEREST 36472470 INVESTMENTS IN UNCONSOLIDATED ORGS - NONCONTROLLING INTEREST 3125437 LEASE RIGHT OF USE ASSETS 52669333 INTERCOMPANY RECEIVABLE 90099627 DEFERRED COMPENSATION 20456211 ESCROW ASSETS 2002427 204825505 INTERCOMPANY PAYABLES 60732845 ENVIRONMENTAL REMEDIATION LIABILITY 1593483 UNCLAIMED PROPERTY 633950 OTHER LIABILITIES 1235920 LEASE RIGHT OF USE LIABILITIES 55351667 CHI DEBT PROGRAM 75219166 PHYSICIAN RECRUIT AND GUARANTEE PAYABLE 20737495 ONPLAN SERVICE FEE LIABILITY 87073 215591599 X PART X, LINE 2: FRANCISCAN HEALTH SYSTEM'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 SUB-SAHARAN AFRICA - ANGOLA, BENIN, BOTSWANA, BURKINA FASO, 0 0 PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 20917 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 0 PROGRAM SERVICES DONATION OF MEDICAL SUPPLIES 3858 0 0 0 0 0 0 24775 0 24775 SUB-SAHARAN AFRICA - ANGOLA, BENIN, BOTSWANA, BURKINA FASO, MEDICAL 0 20917 MED SUPPLIES AND EQUIPMENT COST EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM MEDICAL 0 3858 MED SUPPLIES AND EQUIPMENT COST 1 0 0 0 0 0 0 PART I, LINE 2: FHS ONLY GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY. PART I, LINE 3: THE DONATED MEDICAL SUPPLIES ARE ACCOUNTED FOR AT COST. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 29425129 29425129 0.01470 415591069 342374739 73216330 0.03660 445016198 342374739 102641459 0.05130 52 20946 13645849 1063231 12582618 0.00630 13 1721 12296281 1828831 10467450 0.00520 7 36423 23480200 18436215 5043985 0.00250 17 5718 1928831 1928831 0.00100 89 64808 51351161 21328277 30022884 0.01500 89 64808 496367359 363703016 132664343 0.06630 1 7833 7833 0.00000 4 476 556493 38200 518293 0.00030 5 476 564326 38200 526126 0.00030 1 76019198 250105738 404451250 -154345512 X 0 6 1 ST JOSEPH MEDICAL CENTER 1717 SOUTH J STREET TACOMA WA 98405 VMFH.ORG/OUR-HOSPITALS/ST-JOSEPH-MEDIC HAC.FS.00000032 X X X X A 2 ST ANTHONY HOSPITAL 11567 CANTERWOOD BLVD NW GIG HARBOR WA 98332 VMFH.ORG/OUR-HOSPITALS/ST-ANTHONY-HOSP HAC.FS.60075769 X X X A 3 ST CLARE HOSPITAL 11315 BRIDGEPORT WAY SW LAKEWOOD WA 98499 VMFH.ORG/OUR-HOSPITALS/ST-CLARE-HOSPIT HAC.FS.00000132 X X X A 4 ST FRANCIS HOSPITAL 34515 9TH AVE S FEDERAL WAY WA 98003 VMFH.ORG/OUR-HOSPITALS/ST-FRANCIS-HOSP HAC.FS.00000201 X X X X A 5 VMFH FRANCISCAN REHABILITATION HOSPITAL 815 S VASSAULT ST TACOMA WA 984652008 VMFH.ORG/OUR-HOSPITALS/REHABILITATION- HAC.FS.60833232 X REHAB HOSPITAL A 6 ST ANNE HOSPITAL 16251 SYLVESTER ROAD SW BURIEN WA 98166 VMFH.ORG/OUR-HOSPITALS/ST-ANNE-HOSPITA HAC.FS.00000126 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 24 1 1 1 1 X SEE PART V, PAGE 8 X X 1 25 1 SEE PART V, PAGE 8 0 1 X 300.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-DISCOUNTS X HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-DISCOUNTS X HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/FINANCIAL-ASSISTANCE-DISCOUNTS X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SEC B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. PART V, SEC B, LINE 5 ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, VMFH REHABILITATION HOSPITAL VIRGINIA MASON FRANCISCAN HEALTH CONTRACTS WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT TO CONDUCT AND CREATE THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE HOSPITALS. TO ENSURE MEANINGFUL COMMUNITY ENGAGEMENT, TWO METHODS WERE EMPLOYED TO GATHER AND RECEIVE INPUT - COMMUNITY FEEDBACK SESSIONS AND KEY INFORMANT INTERVIEWS. ASSESSMENT OUTREACH AND ENGAGEMENT WAS SPECIFICALLY DESIGNED TO ENSURE THAT THE VOICES OF OUR BLACK, INDIGENOUS, PERSONS OF COLOR, IMMIGRANT, LGBTQ, MEDICAID, MEDICARE, UNHOUSED, AND YOUTH COMMUNITIES WERE REPRESENTED AND RECOGNIZED. FOUR COMMUNITY FOCUS GROUPS WERE CONDUCTED TO HEAR DIRECTLY FROM RESIDENTS IN SMALL GROUP SETTINGS. ALL FOUR FOCUS GROUPS INCLUDED INDIVIDUALS REPRESENTING DIVERSITY IN RACE, ETHNICITY, GENDER AND SEXUAL ORIENTATION. A CREATIVE ARTS SUBMISSION OPPORTUNITY OFFERED AN ADDITIONAL FEEDBACK MECHANISM FOR LGBTQ AND YOUTH PARTICIPANTS. EIGHT KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS WHO WERE IDENTIFIED BASED ON DISPARITIES AND PRIORITY NEEDS IDENTIFIED IN THE CHNA. THE FOLLOWING COMMUNITY ORGANIZATIONS WERE REPRESENTED IN THE KEY INFORMANT INTERVIEWS OR SUPPORTED THE FOCUS GROUP ENGAGEMENT: BETHEL SCHOOL DISTRICT, TAHOMA INDIAN CENTER, COORDINATED CARE HEALTH, TACOMA PUBLIC SCHOOLS, ELEVATE HEALTH, TACOMA-PIERCE COUNTY HEALTH DEPARTMENT, FRANKLIN PIERCE SCHOOLS, OASIS YOUTH CENTER, TACOMA RESCUE MISSION, PIERCE COUNTY HUMAN SERVICES, AGING & DISABILITY RESOURCES, BLUE ZONES PROJECT, CHILD CARE AWARE, AND NEIGHBORHOOD CLINIC. ST. FRANCIS HOSPITAL, ST. ANNE HOSPITALTO ENSURE REPRESENTATION FROM THE COMMUNITY, NUMEROUS COMMUNITY-BASED ORGANIZATIONS, CLINICS, STATE AND LOCAL AGENCIES, COALITIONS, SCHOOLS AND HOSPITALS HAVE BEEN ENGAGED TO ELEVATE BOTH THE STRENGTHS AND CONCERNS OF THE COMMUNITIES SERVED. ADDITIONALLY, MORE THAN 30 LOCAL COMMUNITY NEEDS ASSESSMENTS, STRATEGIC PLANS, AND REPORTS PRODUCED BETWEEN 2021 AND 2023 THAT INCLUDED ASPECTS OF COMMUNITY ENGAGEMENT WERE REVIEWED TO IDENTIFY NEEDS, PROVIDE CONTEXT TO THE QUANTITATIVE DATA PRESENTED, AND ENHANCE OUR UNDERSTANDING OF KING COUNTY RESIDENTS' PRIORITIES AND STRENGTHS. THROUGH THE COMPREHENSIVE REVIEW OF THE REPORTS AND ASSESSMENTS INCLUDED IN THE CHNA, EACH REGION WITHIN KING COUNTY WAS REPRESENTED, AS WELL AS THE DIVERSE COMMUNITIES THAT MAKE UP THE SERVICE AREA. IN ADDITION TO A REVIEW OF EXISTING REPORTS, LISTENING SESSIONS WERE CONDUCTED WITH COMMUNITIES OF COLOR THROUGHOUT KING COUNTY THAT ARE DISPROPORTIONATELY IMPACTED BY BARRIERS IN ACCESS TO FOOD AND MENTAL/BEHAVIORAL HEALTH SERVICES. ORGANIZATIONS CONTRIBUTING INPUT INCLUDED SEATTLE-KING COUNTY PUBLIC HEALTH, NATIVE AMERICAN PARENT ADVISORY COMMITTEE, ENTRE HERMANOS, SUPPORTIVE COMMUNITY FOR ALL, REFUGEE FEDERATION SERVICE CENTER, GLOBAL TO LOCAL, PACIFIC ISLANDER HEALTH BOARD OF WASHINGTON, FIRST FIVE YEARS AND BEYOND, AND FILIPINO COMMUNITY CENTER. KEY FINDINGS FROM THESE LISTENING SESSIONS PROVIDE A MORE IN-DEPTH UNDERSTANDING OF LOCAL COMMUNITY EXPERIENCES RELATED TO FOOD AND MENTAL/BEHAVIORAL HEALTH SERVICES. PART V, SEC B, LINE 6A ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, VMFH REHABILITATION HOSPITAL OTHER HOSPITALS WHO PARTICIPATED IN THE CHNA INCLUDE ALLENMORE HOSPITAL, GOOD SAMARITAN HOSPITAL, TACOMA GENERAL HOSPITAL, ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, REHABILITATION HOSPITAL, AND WELLFOUND BEHAVIORAL HEALTH HOSPITAL. ST. FRANCIS HOSPITAL, ST. ANNE HOSPITALTHE HOSPITAL SYSTEMS IN KING COUNTY COLLABORATE ON THE CHNA. THE HOSPITAL SYSTEMS WHICH PARTICIPATED IN THE CHNA INCLUDE VIRGINIA MASON FRANCISCAN HEALTH, EVERGREEN HEALTH, KAISER PERMANENTE, MULTICARE HEALTH SYSTEM, OVERLAKE MEDICAL CENTER AND CLINICS, SEATTLE CANCER CARE ALLIANCE, SEATTLE CHILDREN'S, SWEDISH HEALTH SERVICES, AND UW MEDICINE. PART V, SEC B, LINE 6B ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, VMFH REHABILITATION HOSPITAL VIRGINIA MASON FRANCISCAN HEALTH PARTNERS WITH THE TACOMA PIERCE COUNTY HEALTH DEPARTMENT TO COMPLETE AND COMPILE THE CHNA ST. FRANCIS HOSPITAL, ST. ANNE HOSPITALVIRGINIA MASON FRANCISCAN HEALTH PARTNERS WITH PUBLIC HEALTH SEATTLE & KING COUNTY, NAVOS, AND THE WASHINGTON STATE HOSPITAL ASSOCIATION TO CONDUCT AND COMPLETE THE CHNA. PART V, SEC B, LINE 7A HTTPS://WWW.VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPART V, SEC B, LINE 7DTHE CHNA IS SHARED PUBLICLY WITH COMMUNITY PARTNERS AND MEMBERS OF THE COMMUNITY WHO PARTICIPATE IN HEALTH RELATED COALITIONS, PROGRAMS, AND EVENTS. THE CHNA REPORT WAS ALSO SHARED WITH ORGANIZATIONS APPLYING FOR THE COMMONSPIRIT COMMUNITY HEALTH IMPROVEMENT GRANT PROGRAM. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ST. JOSEPH MEDICAL CENTER, - FACILITY 5: VMFH FRANCISCAN REHABILITATION HOSPITAL, - FACILITY 2: ST. ANTHONY HOSPITAL, - FACILITY 3: ST. CLARE HOSPITAL, - FACILITY 4: ST. FRANCIS HOSPITAL, - FACILITY 6: ST. ANNE HOSPITAL FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: NO MINIMUM ACCOUNT BALANCE SHALL BE REQUIRED FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS."PATIENT COOPERATION STANDARDS," AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY, SHALL ONLY APPLY TO THE EXTENT THEY:1) ALLOW THE HOSPITAL FACILITY TO PURSUE REIMBURSEMENT FROM ANY THIRD-PARTY COVERAGE THAT MAY BE IDENTIFIED TO THE HOSPITAL FACILITY, IN ACCORDANCE WITH WAC 246-453-020(1);2) ALLOW THE HOSPITAL FACILITY TO MAKE EVERY REASONABLE EFFORT TO DETERMINE THE EXISTENCE OR NONEXISTENCE OF THIRD-PARTY SPONSORSHIP THAT MIGHT COVER IN FULL OR IN PART THE CHARGES FOR SERVICES PROVIDED TO EACH PATIENT, IN ACCORDANCE WITH WAC246-453-020(4); AND3) DO NOT IMPOSE APPLICATION PROCEDURES FOR CHARITY CARE SPONSORSHIP WHICH PLACE AN UNREASONABLE BURDEN UPON THE RESPONSIBLE PARTY, TAKING INTO ACCOUNT ANY PHYSICAL, MENTAL, INTELLECTUAL, OR SENSORY DEFICIENCIES OR LANGUAGE BARRIERS WHICH MAY HINDER THE RESPONSIBLE PARTY'S CAPABILITY OF COMPLYING WITH THE APPLICATION PROCEDURES, IN ACCORDANCE WITH WAC 246-453-020(5).ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL NOT BE BASED ON A PERSON'S RESIDENCY. PART V, SEC B, LINE 11 ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL.THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MEDICAL CENTER'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDE ACCESS TO CARE, BEHAVIORAL HEALTH, AND CHRONIC DISEASE. THE HOSPITALS ARE TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE: THE MEDICAL CENTER SUPPORTS PROGRAMS THAT HELP THOSE IN NEED WHO ARE UNHOUSED, UNINSURED, UNDERINSURED OBTAIN AFFORDABLE CARE AND IS INCREASING COMMUNITY EDUCATION AND ACCESS TO MATERNAL CHILD HEALTH PROGRAMS. ADDITIONALLY, THE HOSPITALS ARE EXPLORING PARTNERS AND INNOVATIVE SOLUTIONS TO ADDRESS TRANSPORTATION BARRIERS. THROUGH PROJECT ACCESS, INSURANCE PREMIUM SUPPORT, DONATED CARE AND COORDINATION FOR VULNERABLE COMMUNITY MEMBERS IS PROVIDED. SUPPORT FOR MEDICAL RESPITE FOLLOWING A HOSPITAL STAY FOR UNHOUSED PATIENTS IS PROVIDED AND CARE MANAGEMENT STAFF PROVIDE PATIENT SUPPORT TO ASSIST WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING, COUNSELING, AND OTHER NEEDS. THROUGH WIC CLINICS, THE HOSPITAL PROVIDES SUPPLEMENTAL NUTRITION SUPPORT FOR LOW-INCOME FAMILIES AND PREGNANT INDIVIDUALS. MEDICALLY TAILORED FOOD BOXES ARE PROVIDED TO QUALIFIED PATIENTS EXPERIENCING FOOD INSECURITY AND TRANSPORTATION BARRIERS. DONATED LAB WORK IS PROVIDED FOR THE FREE CLINICS IN THE HOSPITALS SERVICE AREA, AND THE HOSPITAL DEDICATES STAFF RESOURCES TO ASSIST PATIENTS WITH INSURANCE ENROLLMENT. GRANT FUNDING IS PROVIDED TO COMMUNITY-BASED ORGANIZATIONS TO ADDRESS ACCESS TO CARE. BEHAVIORAL HEALTH: THE MEDICAL CENTER IS SUPPORTING PROGRAMS THAT BREAK DOWN BARRIERS TO RECEIVING QUALITY MENTAL HEALTH TREATMENT AND EXPANDING AND WORKING WITH PARTNERS TO PROVIDE COMMUNITY EDUCATION AND RESOURCES TO ADDRESS POISONING WHILE EXPANDING BEHAVIORAL HEALTH PROGRAMS THAT FOCUS ON VULNERABLE POPULATIONS. THE MEDICAL CENTER WILL PROVIDE EVIDENCE-INFORMED TRAINING FOCUSED ON REDUCING STIGMA FOR SUBSTANCE USE DISORDERS TO VMFH STAFF AND THE WIDER COMMUNITY AND WILL OFFER A CURRICULUM TO REDUCE SOCIAL ISOLATION IN COMMUNITY ELDERS THROUGH STORYTELLING AND SHARING. GRANT FUNDING IS PROVIDED TO COMMUNITY-BASED ORGANIZATIONS TO ADDRESS BEHAVIORAL HEALTH. CHRONIC DISEASE: THE HOSPITALS ARE SUPPORTING PROGRAMS THAT PREVENT AND MANAGE CHRONIC DISEASE INCLUDING PHYSICAL ACTIVITY, OBESITY, FOOD INSECURITY AND ASTHMA AND IS PARTNERING WITH ORGANIZATIONS WHO REACH UNDERSERVED, LOW-INCOME AND OTHER DISPARATE POPULATIONS WITH CULTURALLY RELEVANT INTERVENTIONS. MEDICALLY TAILORED FOOD BOXES ARE PROVIDED TO QUALIFIED CARDIOLOGY AND DIABETES PATIENTS AS WELL AS NUTRITION EDUCATION. THROUGH A CONGREGATIONAL MINISTRIES PROGRAM, THE HOSPITAL CONTINUES SUPPORTING FAITH COMMUNITIES TO CREATE AND SUSTAIN HEALTH MINISTRIES WHILE SUPPORTING FAITHHEALTH IN ACTION, WHICH HELPS FAITH COMMUNITIES OF COLOR CREATE HEALTH MINISTRIES. BLOOD PRESSURE SCREENINGS AND SUPPORT GROUPS REACH THOSE WITH CHRONIC DISEASE CONDITIONS, AND ANNUAL SCREENINGS ARE OFFERED TO PROVIDE EDUCATION AND SCREENING FOR THE COMMUNITY. GRANT FUNDING IS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS CHRONIC DISEASE. VMFH REHABILITATION HOSPITALSIGNIFICANT NEEDS IDENTIFIED IN THE CHNA INCLUDE BEHAVIORAL HEALTH, CHRONIC DISEASE, AND ACCESS TO CARE. DUE TO THE SPECIALIZED NATURE OF THE VMFH REHABILITATION HOSPITAL AND LIMITED RESOURCES, THE HOSPITAL WILL FOCUS ON ADDRESSING SPECIFIC PARTS OF ACCESS TO CARE, BEHAVIORAL HEALTH CARE AND CHRONIC DISEASE THAT PERTAIN TO INPATIENT REHABILITATION.ACCESS TO CARE: TOWARD IMPROVING ACCESS TO CARE, REHABILITATION HOSPITAL CONNECTS PATIENTS TO RESOURCES TO OBTAIN INSURANCE AND TO SUPPORTIVE PROGRAMS FOR THOSE WHO UTILIZE APPLE HEALTH AS THEIR PRIMARY INSURANCE. THE HOSPITAL ADDRESSES TRANSPORTATION BY PROVIDING TRANSPORTATION FOR PATIENTS WHO HAVE PHYSICAL AND/OR FINANCIAL BARRIERS TO TRANSPORTATION POST DISCHARGE. THE HOSPITAL ALSO CONNECTS PATIENTS TO ORGANIZATIONS WHO CAN ASSIST WITH LONG-TERM TRANSPORTATION NEEDS. THE HOSPITAL STRIVES TO REDUCE BARRIERS TO ACCESSING FINANCIAL ASSISTANCE BY MAKING POLICIES AND MATERIALS WIDELY AVAILABLE IN MULTIPLE LANGUAGES. CHRONIC DISEASE: THE HOSPITAL PROVIDES IN-PATIENT EDUCATION REGARDING LONG TERM CHRONIC DISEASE MANAGEMENT AND OFFERS REHABILITATION PATIENTS MONTHLY STROKE SUPPORT GROUPS AT THE HOSPITAL THAT ARE ALSO OPEN TO THE COMMUNITY. PATIENTS HAVE ALSO BEEN PROVIDED BLOOD PRESSURE CUFFS IN COLLABORATION WITH THE VMFH FAST 58 PROGRAM.BEHAVIORAL HEALTH: THE HOSPITAL WILL CONTINUE TO PROVIDE PSYCHIATRIC SUPPORT AND WILL PROVIDE CONSULTATIONS WITH AN AVP PSYCHOLOGIST AS APPROPRIATE FOR NOT ONLY ADULT DEPRESSION BUT ALSO FOR ADJUSTMENT TO DISABILITY WHILE PATIENTS ARE OBTAINING SERVICES IN THE HOSPITAL. MONTHLY STROKE SUPPORT GROUPS HOSTED AT THE HOSPITAL FOCUS ALSO ON WELL-BEING AND SOCIAL CONNECTIONS.DUE TO THE SPECIALIZED NATURE OF THE HOSPITAL AND LIMITED RESOURCES, THE VMFH REHABILITATION HOSPITAL WILL FOCUS ON ADDRESSING SPECIFIC PARTS OF ACCESS TO CARE, BEHAVIORAL HEALTH CARE AND CHRONIC DISEASE THAT PERTAIN TO INPATIENT REHABILITATION. OTHER VIRGINIA MASON FRANCISCAN HEALTH FACILITIES WILL BE ADDRESSING THE FULL SPECTRUM OF NEEDS FROM THE CHNA.CONTINUED PART V, SEC B, LINE 11 CONTINUED ST. FRANCIS HOSPITAL, ST. ANNE HOSPITAL THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDE ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE AND VIOLENCE PREVENTION. THE HOSPITALS ARE TAKING ACTION AND DEDICATING RESOURCES TO ADDRESS EACH OF THESE PRIORITIES. ACCESS TO CARE: THE HOSPITAL IS SUPPORTING PROGRAMS THAT HELP THOSE IN NEED WHO ARE UNHOUSED, UNINSURED, UNDERINSURED OBTAIN AFFORDABLE CARE AND IS PROVIDING INCREASED COMMUNITY EDUCATION, ACCESS TO MATERNAL CHILD HEALTH PROGRAMS AND RECOMMENDED VACCINATIONS. THROUGH PROJECT ACCESS, VMFH PROVIDES FINANCIAL SUPPORT AND DONATED CARE TO PROJECT ACCESS PROGRAMS ACROSS OUR SERVICE AREA. PROJECT ACCESS PROVIDES INSURANCE PREMIUM SUPPORT, DONATED CARE, AND CARE COORDINATION TO VULNERABLE COMMUNITY MEMBERS. AN EDIBLE FOOD RECOVERY PROGRAM CONNECTS HOSPITAL FOOD WASTE TO LOCAL HUNGER RELIEF ORGANIZATIONS. THE HOSPITAL PROVIDES SUPPORT TO PATIENTS WITH TRANSPORTATION, HOUSING, MEDICAL EQUIPMENT, CLOTHING AND OTHER NEEDS AND CONTINUES TO ENROLL QUALIFIED PATIENTS INTO MEDICAID AND OTHER SUPPORT PROGRAMS. GRANT FUNDING IS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS ACCESS TO CARE. BEHAVIORAL HEALTH: SUPPORT PROGRAMS THAT BREAK DOWN BARRIERS TO RECEIVING QUALITY MENTAL HEALTH TREATMENT. EXPAND BEHAVIORAL HEALTH PROGRAMS THAT FOCUS ON VULNERABLE POPULATIONS, INCLUDING UNHOUSED MEMBERS. NALOXONE KITS ARE PROVIDED AT NO CHARGE FOR PATIENTS WITH A SUBSTANCE USE DISORDER. A LIFETALKS PROGRAM WILL SUPPORT REDUCTION OF SOCIAL ISOLATION IN COMMUNITY ELDERS THROUGH STORYTELLING AND SHARING. AN ANTI-STIGMA PROGRAM FOR SUBSTANCE USE DISORDERS WILL PROVIDE EDUCATION TO INTERNAL STAFF AND THE WIDER COMMUNITY. GRANT FUNDING IS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS BEHAVIORAL HEALTH. CHRONIC DISEASE: SUPPORT PROGRAMS THAT PREVENT AND MANAGE CHRONIC DISEASE INCLUDING PHYSICAL ACTIVITY, OBESITY AND FOOD INSECURITY. PARTNER WITH ORGANIZATIONS REACHING UNDERSERVED, LOW-INCOME AND OTHER DISPARATE POPULATIONS WITH CULTURALLY RELEVANT INTERVENTIONS. A CONGREGATIONAL MINISTRIES PROGRAM SUPPORTS FAITH COMMUNITIES AS THEY CREATE AND SUSTAIN HEALTH MINISTRIES. THE VMFH STROKE TEAM CONDUCTS BLOOD PRESSURE SCREENINGS AT EVENTS THROUGHOUT THE REGION AND TO REDUCE MATERNAL HEALTH DISPARITIES SELF-MONITORED BLOOD PRESSURE INITIATIVES ENHANCED BY DOULA INTEGRATION ARE IMPLEMENTED. THE VMFH COMMUNITY CANCER PROGRAM PROVIDES COMMUNITY SCREENING EVENTS AND EDUCATIONAL EVENTS IN EVERY HOSPITAL COMMUNITY. EDUCATION EVENTS ARE FOCUSED ON PREVENTION AND REMOVING BARRIERS TO SCREENING AND TREATMENT. GRANT FUNDING IS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS CHRONIC DISEASE. VIOLENCE PREVENTION: CONTINUE THE VMFH VIOLENCE PREVENTION INITIATIVE WITH A FOCUS ON SOUTH KING COUNTY. SUPPORT EFFORTS TO PREVENT HUMAN TRAFFICKING AND SEXUAL ASSAULT THROUGH COMMUNITY PARTNERS, COALITIONS, AND HOSPITAL TASK FORCES. A SAFE FIREARM STORAGE PROGRAM REDUCES INCIDENTS OF GUN VIOLENCE THROUGH THE DISTRIBUTION OF SAFE FIREARM STORAGE DEVICES AND PROVIDES EDUCATION ON HOW TO PROPERLY USE THEM. GRANT FUNDING IS PROVIDED TO COMMUNITY BASED ORGANIZATIONS TO ADDRESS VIOLENCE PREVENTION. ST. ANNE HOSPITALDUE TO THE SPECIALIZED NATURE OF THE HOSPITAL AND LIMITED RESOURCES, THE ST. ANNE HOSPITAL WILL FOCUS ON ADDRESSING SPECIFIC PARTS OF ACCESS TO CARE, BEHAVIORAL HEALTH CARE AND CHRONIC DISEASE THAT PERTAIN TO INPATIENT REHABILITATION. OTHER VIRGINIA MASON FRANCISCAN HEALTH FACILITIES WILL BE ADDRESSING THE FULL SPECTRUM OF NEEDS FROM THE CHNA. PART V, LINE 10A, IMPLEMENTATION STRATEGY ON HOSPITAL WEBSITE: HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: * NO MINIMUM ACCOUNT BALANCE SHALL BE REQUIRED FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE* PURSUANT TO THE TERMS OF THE FINANCIAL ASSISTANCE POLICY, UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, CERTAIN ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THIS ADDENDUM UPDATES SUCH ELIGIBILITY CRITERIA WITH THE FOLLOWING:1. ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 300% PERCENT OF THE FPL SHALL RECEIVE A FULL DISCOUNT FROM THEIR ACCOUNT BALANCE FOR APPROPRIATE HOSPITAL BASED MEDICAL SERVICES AND EMERGENCY CARE OR EMERGENCY SERVICES PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY THIRD-PARTY PAYERS OR SPONSORS. 2. ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 301% TO 350% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 75%, WHICH MAY BE REDUCED FROM THEIR ACCOUNT BALANCE FOR APPROPRIATE HOSPITAL BASED MEDICAL SERVICES AND EMERGENCY CARE OR EMERGENCY SERVICES PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY THIRD-PARTY PAYERS OR SPONSORS, AND ANY AMOUNTS REASONABLY RELATED TO ASSETS CONSIDERED AS SET FORTH IN THE HOSPITAL FACILITY'S POLICY ON ASSET TESTING. 3. ANY PATIENT WHOSE FAMILY INCOME IS BETWEEN 351% TO 400% OF THE FPL SHALL RECEIVE DISCOUNTED CARE UP TO 50% FROM THEIR ACCOUNT BALANCE FOR APPROPRIATE HOSPITAL BASED MEDICAL SERVICES AND EMERGENCY CARE OR EMERGENCY SERVICES PROVIDED TO THE PATIENT AFTER PAYMENT, IF ANY, BY ANY THIRD-PARTY PAYERS OR SPONSORS, AND ANY AMOUNTS REASONABLY RELATED TO ASSETS CONSIDERED AS SET FORTH IN THE HOSPITAL FACILITY'S POLICY ON ASSET TESTING. 4. IN THE EVENT A HOSPITAL FACILITY PROVIDES DISCOUNTED CARE GREATER THAN WHAT IS REQUIRED ABOVE (EITHER THROUGH AMOUNTS GENERALLY BILLED ("AGB"), SELF-PAY, OR OTHER DISCOUNTS) THE PATIENT SHALL RECEIVE THAT GREATER DISCOUNTED CARE AMOUNT.* WITH RESPECT TO THOSE ASSETS THAT MAY BE TAKEN INTO CONSIDERATION, HOSPITAL FACILITY WILL SEEK ONLY SUCH INFORMATION REGARDING ASSETS AS IS REASONABLY NECESSARY AND READILY AVAILABLE TO DETERMINE THE EXISTENCE, AVAILABILITY, AND VALUE OF SUCH ASSETS.1. HOSPITAL FACILITY WILL CONSIDER ASSETS AND COLLECT INFORMATION RELATED TO SUCH ASSETS AS REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID ("CMS") FOR MEDICARE COST REPORTING. SUCH INFORMATION MAY INCLUDE REPORTING OF ASSETS CONVERTIBLE TO CASH AND UNNECESSARY FOR THE PATIENT'S DAILY LIVING.2. DUPLICATE FORMS OF VERIFICATION WILL NOT BE REQUESTED AND ONLY ONE CURRENT ACCOUNT STATEMENT IS REQUIRED TO VERIFY MONETARY ASSETS.3. IF NO DOCUMENTATION FOR AN ASSET IS AVAILABLE, A WRITTEN AND SIGNED STATEMENT FROM THE PATIENT OR GUARANTOR IS SUFFICIENT.4. ASSET INFORMATION WILL NOT BE USED FOR COLLECTION ACTIVITIES.THE FOLLOWING TYPES OF ASSETS SHALL BE EXCLUDED FROM CONSIDERATION:-THE FIRST $5,000 OF MONETARY ASSETS FOR AN INDIVIDUAL OR $8,000 OF MONETARY ASSETS FOR A FAMILY OF TWO, PLUS AN ADDITIONAL $1,500 OF MONETARY ASSETS FOR EACH ADDITIONAL FAMILY MEMBER. THE VALUE OF ANY ASSET THAT HAS A PENALTY FOR EARLY WITHDRAWAL SHALL BE THE VALUE OF THE ASSET AFTER THE PENALTY HAS BEEN PAID;-ANY EQUITY IN A PRIMARY RESIDENCE;RETIREMENT PLANS OTHER THAN 401(K) PLANS;-ONE MOTOR VEHICLE AND A SECOND MOTOR VEHICLE IF IT IS NECESSARY FOR EMPLOYMENT OR MEDICAL PURPOSES;-ANY PREPAID BURIAL CONTRACT OR BURIAL PLOT; AND-ANY LIFE INSURANCE POLICY WITH A FACE VALUE OF $10,000 OR LESS ASSISTANCE IS OFFERED TO THOSE WHOSE ANNUAL FAMILY INCOME FALLS WITHIN THE CATEGORIES ABOVE AND HAVE:-COOPERATED WITH EFFORTS TO EXHAUST ALL OTHER PAYMENT OPTIONS; AND-COMPLETED A FINANCIAL ASSISTANCE APPLICATION AND PROVIDED SUFFICIENT SUPPORT TO VERIFY INCOME. IN SOME CASES, PATIENTS MAY BE AWARDED FINANCIAL ASSISTANCE WITHOUT A FORMAL APPLICATION. DETAILS ARE OUTLINED IN THE FINANCIAL ASSISTANCE POLICYTHE PATIENT COOPERATION STANDARDS AS DEFINED IN THE FINANCIAL ASSISTANCE POLICY, SHALL ONLY APPLY TO THE EXTENT THEY:1) ALLOW THE HOSPITAL FACILITY TO PURSUE REIMBURSEMENT FROM ANY THIRD-PARTY COVERAGE THAT MAY BE IDENTIFIED TO THE HOSPITAL FACILITY, IN ACCORDANCE WITH WAC 246-453-020(1);2) ALLOW THE HOSPITAL FACILITY TO MAKE EVERY REASONABLE EFFORT TO DETERMINE THE EXISTENCE OR NONEXISTENCE OF THIRD-PARTY SPONSORSHIP THAT MIGHT COVER IN FULL OR IN PART THE CHARGES FOR SERVICES PROVIDED TO EACH PATIENT, IN ACCORDANCE WITH WAC 246-453-020(4); AND3) DO NOT IMPOSE APPLICATION PROCEDURES FOR CHARITY CARE SPONSORSHIP WHICH PLACE AN UNREASONABLE BURDEN UPON THE RESPONSIBLE PARTY, TAKING INTO ACCOUNT ANY PHYSICAL, MENTAL, INTELLECTUAL, OR SENSORY DEFICIENCIES OR LANGUAGE BARRIERS WHICH MAY HINDER THE RESPONSIBLE PARTY'S CAPABILITY OF COMPLYING WITH THE APPLICATION PROCEDURES, IN ACCORDANCE WITH WAC 246-453-020(5).ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL NOT BE BASED ON A PERSON'S RESIDENCY.COMMONSPIRIT HOSPITAL ORGANIZATIONS RECOGNIZE THAT NOT ALL PATIENTS AND GUARANTORS ARE ABLE TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION OR PROVIDE REQUISITE DOCUMENTATION. FINANCIAL COUNSELORS ARE AVAILABLE AT EACH HOSPITAL FACILITY LOCATION TO ASSIST ANY INDIVIDUAL SEEKING APPLICATION ASSISTANCE. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:-RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;-HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;-PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);-FOOD STAMP ELIGIBILITY;-ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);-LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR-PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.IN THE EVENT THE RESPONSIBLE PARTY'S IDENTIFICATION AS AN INDIGENT PERSON IS OBVIOUS TO HOSPITAL FACILITY PERSONNEL, AND THE HOSPITAL FACILITY PERSONNEL ARE ABLE TO ESTABLISH THE POSITION OF THE INCOME LEVEL WITHIN THE BROAD CRITERIA DESCRIBED IN WAC 246-453-040, BASED ON THE INDIVIDUAL LIFE CIRCUMSTANCES CONTAINED WITHIN THE FINANCIAL ASSISTANCE POLICY OR OTHERWISE, THE HOSPITAL FACILITY IS NOT OBLIGATED TO ESTABLISH THE EXACT INCOME LEVEL OR TO REQUEST DOCUMENTATION FROM THE RESPONSIBLE PARTY, UNLESS THE RESPONSIBLE PARTY REQUESTS FURTHER REVIEW.HOSPITAL FACILITIES SHALL MAKE EVERY REASONABLE EFFORT TO REACH INITIAL AND FINAL DETERMINATIONS OF ELIGIBILITY FOR FINANCIAL ASSISTANCE IN A TIMELY MANNER. NEVERTHELESS, HOSPITAL FACILITIES SHALL MAKE THOSE DETERMINATIONS AT ANY TIME, EVEN AFTER THE APPLICATION PERIOD, UPON LEARNING OF FACTS OR RECEIVING THE DOCUMENTATION DESCRIBED HEREIN, INDICATING THAT THE RESPONSIBLE PARTY'S INCOME IS EQUAL TO OR BELOW THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY GUIDELINES AS ADJUSTED FOR FAMILY SIZE. THE TIMING OF REACHING A FINAL DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL HAVE NO BEARING ON THE HOSPITAL FACILITY'S IDENTIFICATION OF CHARITY CARE DEDUCTIONS FROM REVENUE AS DISTINCT FROM BAD DEBTS. WAC 246-453-020(10). PART I, LINE 7: THE HOSPITALS USE AN ADJUSTED COST TO CHARGE RATIO (CCR) CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 IS USED IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) SOFTWARE TO CALCULATE MEDICAID AND OTHER MEANS-TESTED PROGRAMS EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART II, COMMUNITY BUILDING ACTIVITIES: FRANCISCAN HEALTH SYSTEM PROVIDES JOB SHADOW OPPORTUNITIES TO RESIDENTS EXPLORING HEALTH CARE CAREERS OR SEEKING ENTRY INTO JOB TRAINING PROGRAMS. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR ADDITIONAL DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 301% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: FRANCISCAN HEALTH SYSTEM MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. FRANCISCAN HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. FRANCISCAN HEALTH SYSTEM ALSO UTILIZES A WAYSTAR SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. WAYSTAR USES A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, FRANCISCAN HEALTH SYSTEM DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: FRANCISCAN HEALTH SYSTEM DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2025, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS) AND OTHERS AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 18). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. FRANCISCAN HEALTH SYSTEM'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $154,345,512 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 2: VIRGINIA MASON FRANCISCAN HEALTH STAFF ARE ACTIVE MEMBERS OF NUMEROUS COMMUNITY COALITIONS AND COMMITTEES THROUGHOUT THE SERVICE AREA TO ASCERTAIN AND UNDERSTAND THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. HOSPITALS' PUBLICLY AVAILABLE COMMUNITY HEALTH IMPLEMENTATION STRATEGIES STATE THAT IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY, AND THAT THE POLICY, PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: ST. JOSEPH MEDICAL CENTER, ST. ANTHONY HOSPITAL, ST. CLARE HOSPITAL, VMFH REHABILITATION HOSPITALTHE HOSPITALS SERVE THE WHOLE OF PIERCE COUNTY. THE TOTAL POPULATION OF PIERCE COUNTY IS 946,300. THE COUNTY IS PRIMARILY COMPRISED OF NON-HISPANIC WHITE RESIDENTS. IN 2023, THE HISPANIC POPULATION REPRESENTED 13% OF THE POPULATION, WHILE THE NEXT LARGEST RACIAL GROUP WAS PEOPLE IDENTIFYING AS NON-HISPANIC MULTIRACIAL. ALTHOUGH ALL AGE GROUPS HAVE SEEN AN INCREASE IN THE PERCENTAGE OF NON-WHITE INDIVIDUALS, IT IS PARTICULARLY NOTICEABLE AMONG THE YOUNGER POPULATION. IN 2023, THE PERCENTAGE OF INDIVIDUALS AGED LESS THAN 25 YEARS WHO IDENTIFIED AS BEING NON-WHITE MADE UP OVER HALF OF THIRD (33.6%) IDENTIFIED AS NON-WHITE AMONG THOSE OVER 25 YEARS OF AGE. WHILE PIERCE COUNTY'S POPULATION IS THE SECOND LARGEST IN THE STATE, THE COUNTY INCLUDES URBAN CENTERS AS WELL AS VAST RURAL COMMUNITIES WHERE TRANSPORTATION BARRIERS PERSIST. 15 SCHOOL DISTRICTS ACROSS THE COUNTY SERVE THE GROWING DIVERSITY OF THE INCREASING POPULATION. DURING THE 20232024 SCHOOL YEAR, 51.4% OF STUDENTS IN PIERCE COUNTY WERE ELIGIBLE FOR FREE OR REDUCED-PRICE LUNCH. THIS WAS SLIGHTLY LOWER THAN THE STATE (52.5%).IN PIERCE COUNTY, THE FOUR-YEAR AVERAGE PERCENTAGE OF ADULTS AGED 25 AND OLDER WHO HAVE EARNED AT LEAST A BACHELOR'S DEGREE (29.3%) IS SIGNIFICANTLY LOWER THAN THE STATE AVERAGE (38.0%). AMONG DIFFERENT RACIAL AND ETHNIC GROUPS, NATIVE HAWAIIAN AND PACIFIC ISLANDER RESIDENTS HAVE THE LOWEST ATTAINMENT OF A BACHELOR'S DEGREE (8.5%)HIGHLIGHTING SYSTEMIC BARRIERS TO EDUCATIONAL SUCCESSWHILE ASIAN RESIDENTS HAVE THE HIGHEST (33.0%)REFLECTING DIFFERENT EXPERIENCES AND OPPORTUNITIES. EDUCATIONAL ATTAINMENT IS CLOSELY TIED TO INCOME. INDIVIDUALS WITH INCOMES AT OR ABOVE THE POVERTY LINE (20.5%) WERE MORE LIKELY TO HOLD A BACHELOR'S DEGREE COMPARED TO THOSE BELOW THE POVERTY LINE (14.4%). FROM 20222023, AN AVERAGE OF 12.0% OF ADULTS IN PIERCE COUNTY REPORTED THAT THE FOOD THEY BOUGHT ALWAYS OR SOMETIMES DIDN'T LAST, AND THEY DIDN'T HAVE ENOUGH MONEY TO BUY MORE. THIS WAS HIGHER THAN THE STATE 2-YEAR AVERAGE OF 10.5%. IN PIERCE COUNTY, LIFE EXPECTANCY WAS LOWER THAN THE STATE AVERAGE. WOMEN IN THE COUNTY GENERALLY HAD A LONGER LIFE EXPECTANCY THAN MEN. AMONG RACIAL GROUPS, INDIVIDUALS IDENTIFYING AS MULTIRACIAL HAD THE HIGHEST LIFE EXPECTANCY (98.6 YEARS), WHILE NATIVE HAWAIIAN OR PACIFIC ISLANDER POPULATIONS HAD THE LOWEST LIFE EXPECTANCY (67.6 YEARS). ST. FRANCIS HOSPITAL, ST ANNE HOSPITALTHE PRIMARY SERVICE AREA FOR ST. FRANCIS HOSPITAL AND ST. ANNE HOSPITAL IS KING COUNTY, WA , WHICH HAS OVER 2.3 MILLION RESIDENTS AND COVERS OVER 2,300 SQUARE MILES. POPULATION GROWTH IS HIGHLIGHTED BY INCREASING RACIAL, ETHNIC AND LINGUISTIC DIVERSITY WITH 47% OF THE POPULATION IDENTIFYING AS NON-WHITE. NOTABLY, 62% OF THOSE UNDER 18 IDENTIFY AS INDIVIDUALS OF COLOR. INTERNATIONAL MIGRATION REMAINED A KEY COMPONENT TO THE COUNTY'S POPULATION GROWTH BETWEEN 2020-2022, IN LINE WITH OTHER MAJOR METRO COUNTIES AROUND THE COUNTRY. KING COUNTY WAS 4TH IN THE NATION FOR INTERNATIONAL NET MIGRATION DURING THIS PERIOD, ACCORDING TO THE CENSUS BUREAU. WHILE OVERALL RATES OF THOSE UNINSURED REMAIN STABLE, RACIAL AND ETHNIC DISPARITIES IN HEALTH AND SOCIAL OUTCOMES PERSIST THROUGHOUT THE COUNTY. A CONTINUING TREND REFLECTS WHITE AND ASIAN POPULATIONS IN KING COUNTY FARE BETTER THAN OTHER RACIAL/ETHNIC GROUPS ACROSS SEVERAL HEALTH AND SOCIAL INDICATORS. IN 2022, THE RATE OF UNINSURANCE FOR ADULTS WITH HISPANIC ETHNICITY WAS THREE TIMES THE KING COUNTY AVERAGE. AMERICAN INDIAN/ALASKA NATIVE ADULTS WERE MORE THAN FOUR TIMES AS LIKELY TO BE UNINSURED COMPARED TO WHITE ADULTS, WHO HAD THE LOWEST RATE OF UNINSURANCE COMPARED TO OTHER RACES. THE COUNTY IS DIVIDED INTO FOUR GEOGRAPHIC REGIONS: SEATTLE, NORTH, SOUTH, AND EAST. ACROSS FOUR REGIONS THERE ARE 19 PUBLIC SCHOOL DISTRICTS (AS WELL AS CHARTER SCHOOLS, PRIVATE SCHOOLS, AND THE MUCKLESHOOT TRIBAL SCHOOL. DISPARITIES ARE EVIDENT IN LIFE EXPECTANCY AND REVEAL THOSE IDENTIFYING AS NATIVE HAWAIIAN/PACIFIC ISLANDER, AMERICAN INDIAN/ALASKA NATIVE, AND BLACK EXPERIENCE A LIFE EXPECTANCY OF FIVE TO 12 YEARS SHORTER THAN THE LIFE EXPECTANCY OF WHITE ADULTS. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL AND MARKET COMMUNITY BOARDS OF COMMUNITY ADVISORS (OR THEIR DESIGNATED COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 24 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS. COMMONSPIRIT HEALTH AND SUBSTANTIALLY ALL OF ITS DIRECT AFFILIATES AND SUBSIDIARIES HAVE BEEN GRANTED EXEMPTIONS FROM FEDERAL NCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF SEPTEMBER 24, 2025, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,300 CARE SITES, CONSISTING OF 138 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. AN ADDITIONAL 20 HOSPITALS ARE OPERATED THROUGH UNCONSOLIDATED JOINT VENTURES. IN FISCAL YEAR 2025, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.071 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.156 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $39.1 BILLION IN FISCAL YEAR 2025, HAS TOTAL ASSETS OF APPROXIMATELY $57.26 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. PART VI, LINE 7, REPORTS FILED WITH STATES WA 1 PIERCE COUNTY PROJECT ACCESS 4301 S PINE ST TACOMA WA 98409 271185895 501(C)(3) 201241 0 PROGRAM SUPPORT URBAN FAMILY CENTER ASSN 746 INDUSTRY DRIVE TUKWILA WA 98188 273962439 501(C)(3) 40916 0 PROGRAM SUPPORT MULTICULTURAL CHILD & FAMILY 2021 S 19TH ST TACOMA WA 98405 352266626 501(C)(3) 96000 0 PROGRAM SUPPORT YETI 7601 SOUTHWEST PARKWAY AUSTIN TX 78735 455297111 501(C)(3) 41195 0 PROGRAM SUPPORT INTERCULTURAL CHILDREN & FAMILY 15 S GRADY WAY STE 434 RENTON WA 98057 463280147 501(C)(3) 47382 0 PROGRAM SUPPORT SOMALI HEALTH BOARD 545 ANDOVER PARK WEST SUITE 105 TUKWILA WA 98188 465114580 501(C)(3) 46362 0 PROGRAM SUPPORT RVC SEATTLE 3715 S HUDSON ST STE 103 SEATTLE WA 98118 474257834 501(C)(3) 24999 0 PROGRAM SUPPORT MARVIN WILLIAMS RECREATION CTR 725 PARK AVENUE BREMERTON WA 98337 481272428 501(C)(3) 75000 0 PROGRAM SUPPORT EMERGENCY FOOD NETWORK PO BOX 4373 CHARLOTTESVILLE WA 22905 510137371 501(C)(3) 75000 0 PROGRAM SUPPORT UTOPIA WASHINGTON (UNITED TERRITORIES OF PACIFIC ISLANDERS) 841 CENTRAL AVE N SUITE C106 KENT WA 98032 611668192 501(C)(3) 40908 0 PROGRAM SUPPORT KITSAP IMMIGRANT ASSISSTANCE CENTER 3627 WHEATON WAY SUITE 106 BREMERTON WA 98310 753182528 501(C)(3) 100000 0 PROGRAM SUPPORT LATINO CIVIC ALLIANCE 1037 NE 65TH ST SUITE 194 SEATTLE WA 98115 800635220 501(C)(3) 40908 0 PROGRAM SUPPORT UNLEASH THE BRILLIANCE 27005 164TH AVE SE COVINGTON WA 98042 800773742 501(C)(3) 46362 0 PROGRAM SUPPORT COMMUNITY PASSAGEWAYS 7728 RAINIER AVE S SEATTLE WA 98118 813806946 501(C)(3) 46362 0 PROGRAM SUPPORT GAME OF LIFE FOUNDATION 3033 EXCELSIOR BLVD STE 100 MINNEAPOLIS MN 55416 820675073 501(C)(3) 92730 0 PROGRAM SUPPORT PHENOMENAL SHE 1612 SW DASH POINT RD FEDERAL WAY WA 98023 825072798 501(C)(3) 69544 0 PROGRAM SUPPORT AFRICAN COMMUNITY HOUSING & DEVELOPMENT 16256 MILITARY RD S SUITE 206 SEATAC WA 98188 831665288 501(C)(3) 30909 0 PROGRAM SUPPORT THE JOURNEY FUND PO BOX 385 GRAHAM WA 98338 832831864 501(C)(3) 35000 0 PROGRAM SUPPORT CASCADE PUBLIC SCHOOLS 22419 PACIFIC HIGHWAY SOUTH 3 DES MOINES WA 98198 833285687 501(C)(3) 87293 0 PROGRAM SUPPORT BUILD2LEAD PO BOX 23131 FEDERAL WAY WA 98093 845112432 501(C)(3) 34090 0 PROGRAM SUPPORT CJK COMMUNITY HOMES 2367 TACOMA AVE S STE 215 TACOMA WA 98402 850591204 501(C)(3) 12564 0 PROGRAM SUPPORT PROJECT BE FREE 306 WELLS AVE S SUITE D RENTON WA 98057 852820252 501(C)(3) 41044 0 PROGRAM SUPPORT KEY PENINSULA HEALTH COMMUNITY PO BOX 695 VAUGHN WA 98394 862537545 501(C)(3) 66500 0 PROGRAM SUPPORT YMCA OF PIERCE & KITSAP CTY 4717 S 19TH STREET SUITE 201 TACOMA WA 98405 910565562 501(C)(3) 89600 0 PROGRAM SUPPORT TACOMA URBAN LEAGUE 2550 S YAKIMA AVE UNIT A TACOMA WA 98405 910826302 501(C)(3) 50000 0 PROGRAM SUPPORT SEATTLE CENTER FOUNDATION 305 HARRISON STREET 310 SEATTLE WA 98109 911003385 501(C)(3) 31336 0 PROGRAM SUPPORT REFUGEE WOMENS ALLIANCE 4008 MLK JR WAY SEATTLE WA 98108 911296964 501(C)(3) 50000 0 PROGRAM SUPPORT MULTICARE HEALTH SYSTEMS PO BOX 5299 TACOMA WA 98415 911352172 501(C)(3) 437500 0 PROGRAM SUPPORT MUSEUM OF GLASS 1801 DOCK STREET TACOMA WA 98402 911669422 501(C)(3) 20000 0 PROGRAM SUPPORT PLATEAU OUTREACH MINISTRIES 1806 COLE ST ENUMCLAW WA 98022 911965830 501(C)(3) 30000 0 PROGRAM SUPPORT VINE MAPLE PLACE PO BOX 1092 MAPLE VALLEY WA 98038 912082308 501(C)(3) 100000 0 PROGRAM SUPPORT EAST AFRICAN COMMUNITY SERVICES 7050 32ND AVE S SEATTLE WA 98118 912138852 501(C)(3) 52601 0 PROGRAM SUPPORT HIDDEN QUEENS 34620 4TH PL SW FEDERAL WAY WA 98023 922207612 501(C)(3) 41500 0 PROGRAM SUPPORT 33 0 PART I, LINE 2: FHS ONLY GRANTS TO 501(C)(3) AND 501(C)(6) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY. 1 1 0 0 0 0 0 0 0 KETUL PATEL CEO VMFH & PRESIDENT NORTHWEST REGIO 0 1399822 0 4002957 0 263122 0 74757 0 14201 0 5754859 0 0 CHARLEEN TACHIBANA RN REGION CHIEF QUALITY-SAFETY-PATIENT 376942 0 240477 0 961437 0 15755 0 16637 0 1611248 0 0 0 JAMES TERWILLIGER PRESIDENT, PUGET SOUND MARKET (THRU 731360 0 644862 0 14085 0 93125 0 3089 0 1486521 0 0 0 THOMAS KRUSE REGION CHIEF STRATEGY OFFICER-NW 742882 0 281456 0 4866 0 14723 0 26324 0 1070251 0 0 0 DAVID NOSACKA TREASURER/SVP&CFO NORTHWEST REGION 624949 0 243163 0 4198 0 20325 0 41647 0 934282 0 0 0 RUSSELL WOOLLEY FORMER COO ST FRANCIS & ST ANNE HOSP 0 421092 0 181409 0 106356 0 60653 0 42290 0 811800 0 0 RYAN PONG REGION VP ACADEMIC OFFICER NW 541575 0 210611 0 2160 0 16300 0 40598 0 811244 0 0 0 DIANNE AROH REGION CHIEF NURSING OFFICER-NW (THR 545046 0 210445 0 10401 0 20325 0 3089 0 789306 0 0 0 KIMBERLY MOORE VP/INTERIM CHIEF MEDICAL OFFICER (TH 527941 0 200532 0 4745 0 17146 0 16801 0 767165 0 0 0 HANS CASSAGNOL CHIEF MEDICAL OFFICER NW 448102 0 71200 0 196755 0 3798 0 19118 0 738973 0 0 0 INGRID GERBINO CHIEF INNOVATION OFFICER 473073 0 183937 0 4660 0 20325 0 13320 0 695315 0 0 0 TOBY SUTTON REGION CHRO-NW 418026 0 153239 0 25124 0 12075 0 7253 0 615717 0 0 0 DAVID WEISS FORMER MKT VP MEDICAL OPERATIONS 433971 0 118685 0 6553 0 20111 0 20937 0 600257 0 0 0 DAVID BUTCHERITE FORMER TREASURER/REGION VP FINANCE N 327472 0 128643 0 4883 0 18694 0 23163 0 502855 0 0 0 MIRIAM CHAMBLISS CORPORATE SECRETARY/VP GENERAL COUNS 0 306158 0 121211 0 1290 0 12689 0 32951 0 474299 0 0 SHARON ROYNE FORMER KE/VP ADMINISTRATIVE SERVICES 399961 0 600 0 5988 0 15367 0 23462 0 445378 0 0 0 MATTHEW METSKER PA-C MPAS MHA CMPE PRESIDENT ST CLARE HOSPITAL 288481 0 80486 0 18188 0 18630 0 32233 0 438018 0 0 0 MICHAEL COX FORMER KEY EMPLOYEE/CHIEF MISSION OF 270004 0 109687 0 1209 0 16398 0 39794 0 437092 0 0 0 DINO JOHNSON PRESIDENT ST ANTHONY HOSPITAL 303102 0 70244 0 619 0 15410 0 37258 0 426633 0 0 0 DEEPAK DEVASTHALI PRESIDENT ST. JOSEPH MEDICAL CENTER 277404 0 51518 0 666 0 18784 0 35400 0 383772 0 0 0 JENNIFER SCHOMBURG PRESIDENT ST JOSEPH MEDICAL CENTER ( 302248 0 0 0 1332 0 14322 0 16132 0 334034 0 0 0 SYDNEY BERSANTE FORMER INTERIM PRESIDENT SJMC 169231 0 0 0 0 0 12469 0 14 0 181714 0 0 0 LOIS ERICKSON PRESIDENT ST CLARE HOSPITAL (THRU 5/ 96722 0 60900 0 3334 0 10040 0 9433 0 180429 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2024, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH, USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. SCH J, PART I, LINE 4A CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2024 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): CHARLEEN TACHIBANA, $952,588. SCH J, PART I, LINE 4B CERTAIN LISTED PERSONS PARTICIPATE IN THE COMMONSPIRIT HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), A NONQUALIFIED RETIREMENT PLAN DESIGNED TO PROVIDE DEFERRED COMPENSATION TO KEY EXECUTIVES WHO HAVE CONTRIBUTED MATERIALLY TO THE SUCCESS OF OUR MINISTRY. THE SERP IS INTENDED TO PROVIDE HIGHLY COMPENSATED INDIVIDUALS WITH ADDITIONAL RETIREMENT INCOME TO HELP OFFSET REGULATORY LIMITS IN PLACE ON QUALIFIED RETIREMENT PLANS AND SOCIAL SECURITY. EACH ANNUAL CONTRIBUTION IS SUBJECT TO A FOUR-YEAR VESTING OR RETENTION PERIOD. UPON COMPLETION OF THE APPLICABLE FOUR-YEAR RETENTION PERIOD FOR EACH ANNUAL CONTRIBUTION, VESTING WILL OCCUR, AND ANY ACCUMULATED BENEFIT UNDER THE PLAN WILL BE RECEIVED. ON THE FIRST DAY OF THE CALENDAR MONTH AFTER THE FOURTH ANNIVERSARY OF THE SERP BENEFIT, THE ANNUAL CONTRIBUTION AND ITS ASSOCIATED INVESTMENT GAINS OR LOSSES BECOME 100% VESTED. IN ADDITION, THE PARTICIPANT'S SERP BENEFIT BECOMES 100% VESTED UPON ANY OF THE FOLLOWING EVENTS: 1) REACHING THE AGE OF 65 (THE PLAN'S NORMAL RETIREMENT AGE), OR 2) DEATH, OR BECOME DISABLED UNDER THE LONG-TERM DISABILITY PLAN OR SOCIAL SECURITY. SHOULD EMPLOYMENT END FOR ANY REASON OTHER THAN TERMINATION WITH SEVERANCE, RETIREMENT AT AGE 65 OR OLDER, DISABILITY, OR DEATH, UNVESTED SERP FUNDS ARE FORFEITED. IF EMPLOYMENT IS TERMINATED WITH SEVERANCE, THE TERMS AND CONDITIONS OUTLINED WITHIN THE SERP, AND NOT THOSE OF ANY SEVERANCE AGREEMENT, WILL CONTROL AND GOVERN PAYMENT ENTITLEMENT UNDER THE SERP. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN THE CATHOLIC HEALTH INITIATIVES SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR REGION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2024 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2024, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: KETUL J. PATEL, $244,754. VIRGINIA MASON MEDICAL CENTER MAINTAINED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR ELIGIBLE SENIOR EXECUTIVES. THE SERP IS A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN PURSUANT TO WHICH PLAN BENEFITS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE PLAN WAS APPROVED BY THE BOARD'S COMPENSATION AND BENEFITS COMMITTEE, A COMMITTEE COMPOSED OF INDEPENDENT BOARD MEMBERS TO WHOM THE BOARD DELEGATES THE AUTHORITY TO APPROVE COMPENSATION AND BENEFITS FOR THE MEDICAL CENTER'S MOST SENIOR EXECUTIVES. THE COMMITTEE RECEIVES ADVICE FROM AN INDEPENDENT COMPENSATION CONSULTANT TO ENSURE THAT COMPENSATION AND BENEFITS, INCLUDING THE SERP, ARE MARKET COMPETITIVE AND REASONABLE. SCHEDULE J, PART II FRANCISCAN HEALTH SYSTEM FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE PEOPLE AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2024. GILES NOSACKA FAMILY MEMBER OF AN OFFICER 135404 EMPLOYEE PAYROLL WAGES 0 HANNAH HUNTHAUSEN FAMILY MEMBER OF A DIRECTOR 131761 EMPLOYEE PAYROLL WAGES 0 CHELSEA METSKER FAMILY MEMBER OF A KEY EMPLOYEE 43627 EMPLOYEE PAYROLL WAGES 0 FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY FRANCISCAN HEALTH SYSTEM. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF FRANCISCAN HEALTH SYSTEM ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS COMMONSPIRIT HEALTH, A COLORADO NON PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH (CSH). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CSH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CSH CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF FHS - AMENDMENT OF THE CORPORATE DOCUMENTS OF FHS - APPROVE MEMBERS OF THE FHS BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FHS - APPROVAL OF ISSUANCE OF DEBT BY FHS - APPROVAL OF PARTICIPATION OF FHS IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY FHS - APPROVAL OF A MERGER INVOLVING THE FHS - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FHS - TO REQUIRE THE TRANSFER OF ASSETS BY FHS TO CSH TO ACCOMPLISH CSH'S GOALS AND OBJECTIVES, AND TO SATISFY CSH DEBTS. - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR FHS PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CSH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWS THE FORM AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. THE CFO ALSO PROVIDES THE RETURN TO THE BOARD, AND ALL BOARD MEMBERS HAVE THE OPPORTUNITY TO REVIEW THE 990 PRIOR TO FILING WITH THE IRS. SUBSEQUENT TO REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AS SOON AS THEY BECOME AWARE OF IT AND AT LEAST ANNUALLY THEREAFTER (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS AS FURTHER DESCRIBED BELOW. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. STANDARD MANAGEMENT APPROACHES PER COI POLICY ARE APPLIED TO DISCLOSED CONFLICTS. DISCLOSURES THAT IDENTIFY PERCEIVED, POTENTIAL, OR ACTUAL COIS THAT REQUIRE IMMEDIATE MATERIAL ACTION TO RESOLVE, WILL BE IDENTIFIED, AND, A CONFLICT OF INTEREST MANAGEMENT PLAN DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A PEOPLE AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR ADOPTING A REASONABLE COMPENSATION PHILOSOPHY AND SETTING REASONABLE COMPENSATION PRACTICES FOR THE ORGANIZATION. COMMONSPIRIT'S COMPENSATION DEPARTMENT ENSURES THAT ITS PRACTICES ARE CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY, PRACTICES, AND PRINCIPLES, AS DETERMINED BY THE PEOPLE AND COMPENSATION COMMITTEE. WHEN NECESSARY, THE COMPENSATION DEPARTMENT ALSO ENGAGES AN INDEPENDENT CONSULTANT, AS WELL AS QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO VALIDATE THE ORGANIZATION'S BENCHMARKING APPROACH FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES FOR CERTAIN EXECUTIVES. APPROPRIATE COMPARABILITY DATA IS ALSO OBTAINED BY THE COMMONSPIRIT HEALTH COMPENSATION DEPARTMENT FROM INDEPENDENT THIRD-PARTY SALARY SURVEYS, AS PART OF THE ORGANIZATION'S COMPENSATION PRACTICES (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). THE DOCUMENTATION OF COMPENSATION DECISIONS INCLUDES THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMPENSATION DEPARTMENT AND THE SOURCES FROM WHICH THE DATA WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG OR WWW.CATHOLICHEALTHINITIATIVES.ORG. FORM 990, PART VI, SECTION B, LINE 16B: FRANCISCAN HEALTH SYSTEM HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 106,256,610. MANAGEMENT AND GENERAL EXPENSES 11,806,290. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 118,062,900. CONSULTING: PROGRAM SERVICE EXPENSES 2,746,876. MANAGEMENT AND GENERAL EXPENSES 4,120,314. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,867,190. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 28,368,281. MANAGEMENT AND GENERAL EXPENSES 18,912,187. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,280,468. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 79,517,714. MANAGEMENT AND GENERAL EXPENSES 8,835,302. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 88,353,016. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 118,741,013. MANAGEMENT AND GENERAL EXPENSES 29,674,021. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 148,415,034. FORM 990, PART XI, LINE 9: AFFILIATE TRANSFERS -207,769,846. CHANGES IN EQUITY OF UNCONSOLIDATED ORGS 6,578,943. NON-CONTROLLING OWNERSHIP CHANGES -503,982. SERP LIABILITY ADJUSTMENT -43,034. ASSETS RELEASED FOR CAPITAL 397,517. 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