2024-06-14T17:00:04-05:00 2023-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2023-01-01 911286274 SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION SUNN 5098371500 PO BOX 719 SUNNYSIDE WA 98944 MAXWELL OWENS CFO 5098371500 2024-06-14 1 MAXWELL OWENS 999009999 0 COLLEEN RAMIRES P01251320 4252597227 2024-06-14 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z ASTRIA SUNNYSIDE HOSPITAL BRIAN GIBBONS PO BOX 719 SUNNYSIDE WA 98944 128924851 0 X WWW.ASTRIA.HEALTH X 1985 WA PROVIDE COMPREHENSIVE QUALITY HEALTHCARE TO THE REGION. 6 5 559 6 0 0 398815 128975 108788504 128343350 4591 27918 245583 424608 109437493 128924851 0 0 0 0 38730561 43134332 0 0 0 67959073 75290684 106689634 118425016 2747859 10499835 58448824 71481385 14123021 16655747 44325803 54825638 PROVIDE COMPREHENSIVE QUALITY HEALTHCARE TO THE REGION. 0 0 78112793 128343350 SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION (THE ASSOCIATION) IS COMPRISED OF A 25-BED CRITICAL ACCESS HOSPITAL AND A SERIES OF EIGHT RURAL HEALTH CLINICS, A FAMILY BIRTH CENTER, COMPLETE SURGICAL SERVICES, LABORATORY, 4-D OBSTETRICAL ULTRASOUND, DIGITAL MAMMOGRAPHY, CARDIOPULMONARY SERVICES, REGISTERED DIETICIAN AND DIABETES EDUCATOR SERVICES. THE ASSOCIATION PROVIDED 1,274 HOSPITAL ADMISSIONS, 76,049 OUTPATIENT VISITS, 16,031 EMERGENCY ROOM VISITS, AND 223 BIRTHS DURING THE YEAR. THE ASSOCIATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $185,129,679 FOR CHARITY CARE, MEDICARE, MEDICAID AND OTHER THIRD PARTY PAYORS FOR THE YEAR. 78112793 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 122 0 1 559 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MAXWELL OWENS 5098371379 1016 TACOMA AVE SUNNYSIDE WA 98944 BRIAN GIBBONS CEO 10.00 30.00 X X 0 841777 57034 CHRISTINA RIVAS BOARD CHAIR 1.00 1.00 X X 0 0 0 SUZY FONSECA BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 JAY RODNE SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 PEGGY BREWER TRUSTEE (THRU 10/23) 1.00 2.00 X 0 0 0 JONATHAN G MERCER TRUSTEE 1.00 2.00 X 0 0 0 BRYAN SANDLIN TRUSTEE 1.00 1.00 X 0 0 0 MAXWELL OWENS CFO 10.00 30.00 X 0 652831 30174 WINNIE ADAMS CNO 40.00 X 0 220098 49574 DAVID SHOEMAKER PHYSICIAN, CHIEF OF STAFF 39.00 1.00 X 851432 0 29208 ERNESTO DIZON MD PHYSICIAN 40.00 X 805974 0 56647 PETER GRUNERT MD PHYSICIAN 40.00 X 791828 0 26054 MANUEL YBANEZ MD PHYSICIAN 40.00 X 637346 0 24431 BRAD WARD MD PHYSICIAN 40.00 X 610459 0 50178 3697039 1714706 323300 88 0 1 0 AYA HEALTHCARE PO BOX 674907 DALLAS TX 75267 CONTRACT LABOR 2568925 SUNNYSIDE EMERGENCY GROUP PO BOX 677979 DALLAS TX 75267 PROFESSIONAL PHYSICIAN SERVICES 1271608 RURAL PHYSICIANS GROUP 5575 DTC PARKWAY STE 225 GREENWOOD VILLAGE CO 80111 PROFESSIONAL PHYSICIAN SERVICES 1061461 EVERGREEN ANESTHESIA ASSOCIATES 3800 S HIGHLANDS RD WEST RICHLAND WA 99353 ANESTHESIA SERVICES 966737 PULMONARY EXCHANGE 7880 WICKER AVE UNIT 7 ST JOHN IN 46373 RESPIRATORY SERVICES 828703 33 88295 40680 128975 NET PATIENT SERVICE REVENUE 624100 128298916 128298916 OTHER HEALTH REVENUE 624100 44434 44434 128343350 27918 27918 DIETARY REVENUE 722514 311218 311218 OTHER REVENUE 900099 163250 163250 SUBSIDIARY LOSS 900099 -49860 -49860 424608 128924851 128343350 0 452526 33676419 27876010 5800409 984622 282070 702552 6193780 1774366 4419414 2279511 653024 1626487 1189145 1189145 16624 16027 597 74375 74375 7040703 6787932 252771 1987639 1835993 151646 130683 120713 9970 2009510 991633 1017877 179489 22775 156714 132550 16819 115731 4471765 68703 4403062 2154597 2154597 1769435 4584 1764851 MEDICAL SUPPLIES 15810862 15810862 CORPORATE OVERHEAD 13911279 1765155 12146124 PURCHASED SERVICES 11377524 9021894 2355630 BAD DEBT 10777901 10777901 2256603 286332 1970271 118425016 78112793 40312223 0 2352656 4762820 544383 2904184 16664604 21335839 2828936 2982615 306230 245610 62488617 47115473 16903934 15373144 358022 319512 441667 391667 18048392 23165994 58448824 71481385 11517604 13331226 2605417 3324521 14123021 16655747 X 44325803 54825638 44325803 54825638 58448824 71481385 10499835 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5072349 5072349 23909134 17615379 6293755 32046106 28400139 3645967 1461028 1099955 361073 15373144 RELATED PARTY RECEIVABLES 19764593 LEASE RIGHT-OF-USE ASSETS 3287273 OTHER RECEIVABLE 114128 23165994 LEASE LIABILITIES 3324521 3324521 X PART X, LINE 2: THE ORGANIZATION COMPRISES SEVERAL CORPORATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515, AND SEVERAL LIMITED LIABILITY COMPANIES. THE ORGANIZATION HAS ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS, WHICH IS AN ACCOUNTING STANDARD THAT PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2023. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 1366523 1366523 0.01270 34425756 29456348 4969408 0.04620 35792279 29456348 6335931 0.05890 431385 431385 0.00400 431385 431385 0.00400 36223664 29456348 6767316 0.06290 1 10777901 21653707 21673909 -20202 X 1 1 1 1 SUNNYSIDE COMMUNITY HOSPITAL PO BOX 719 SUNNYSIDE WA 98944 WWW.ASTRIA.HEALTH X X X X X SUNNYSIDE COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X 21 1 1 0 1 X SEE PART V X 1 22 1 SEE PART V 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X 1 X 0 0 SUNNYSIDE COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: TO ASSURE COMMUNITY ENGAGEMENT AND VOICE IN THE CHNA PROCESS, ASTRIA HAD PLANNED A ROBUST IN-PERSON COMMUNITY CONVENING PROCESS TO ASSESS, IDENTIFY, AND PRIORITIZE COMMUNITY NEEDS. AFTER MUCH DISCUSSION, DUE TO THE UNRELENTING NATURE OF COVID IN THE COMMUNITY, ASTRIA CHOSE TO USE A COMBINATION OF ONLINE SURVEYS, FOCUS GROUPS AND ONE-ON-ONE PHONE INTERVIEWS WITH SERVICE AREA AND COUNTY COMMUNITY MEMBERS AND ORGANIZATIONS SERVING THE VULNERABLE. A SIMILAR PROCESS WAS USED WITH ASTRIA LEADERSHIP AND MANAGEMENT. KEY STAKEHOLDER INTERVIEWS: STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY INCLUDING PUBLIC HEALTH, TRIBAL HEALTH, AND INDIVIDUALS WITH KNOWLEDGE OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE. INDIVIDUALS TO BE INTERVIEWED WERE RECOMMENDED BY ASTRIA HEALTH SENIOR LEADERSHIP.KEY STAKEHOLDER SURVEY: A KEY STAKEHOLDER SURVEY WAS DISTRIBUTED TO PROVIDERS (PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS), THE CLINICAL MANAGEMENT STAFF OF ASTRIA HEALTH, AND COMMUNITY ORGANIZATIONS WITH KNOWLEDGE AND EXPERTISE REGARDING THE NEEDS OF UNDERSERVED, AT-RISK AND VULNERABLE POPULATIONS, AND THOSE WITH CHRONIC DISEASE. SURVEYS WERE RECEIVED FROM THE FOLLOWING ORGANIZATION TYPES:- CITY GOVERNMENT- SCHOOLS- HIGHER EDUCATION AND WORK FORCE DEVELOPMENT- COMMUNITY SERVICE ORGANIZATIONS- SOCIAL SERVICES AGENCIES- COMMUNITY HEALTH CENTERS- HOSPITAL PROVIDERS- LOCAL BUSINESSES- LOCAL UTILITY ORGANIZATIONS- EMERGENCY RESPONDERSTHE FOLLOWING NUMBER OF RESPONSES WERE RECEIVED FROM SURVEYS AND FOCUS GROUPS: - INTERVIEW WITH YAKIMA HEALTH DISTRICT - 15 COMMUNITY SURVEYS - 29 ASTRIA HEALTH MANAGERS AND LEADERSHIP SURVEYS - 8 FOCUS GROUP PARTICIPANTS - 3 INDIVIDUAL MEETINGS ASTRIA HEALTH CONTRACTED WITH HEALTH FACILITIES PLANNING & DEVELOPMENT (HFPD) TO ASSIST IN CONDUCTING THE CHNA. HFPD IS A HEALTH CARE CONSULTING COMPANY BASED IN SEATTLE, WASHINGTON. SUNNYSIDE COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: SHC MEDICAL CENTER - TOPPENISH (DBA ASTRIA TOPPENISH HOSPITAL) SUNNYSIDE COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: UTILIZING THE PRIORITIZATION CRITERIA AND GROUP DISCUSSION, THE SENIOR LEADERSHIP TEAM CHOSE THREE PRIORITY COMMUNITY HEALTH NEEDS AS FOCUS AREAS FOR ASTRIA HEALTH OVER THE NEXT THREE YEARS. THESE COMMUNITY HEALTH NEEDS ARE IDENTIFIED AND ADDRESSED IN THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE IN ALIGNMENT WITH THE COMMUNITY HEALTH NEEDS IDENTIFIED BY KEY STAKEHOLDERS. LISTED BELOW ARE THE THREE SIGNIFICANT NEEDS AND HOW THE HOSPITAL IS ADDRESSING THESE NEEDS.(1) INCREASE ACCESS TO BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES.- CONTINUE EFFORTS TO INTEGRATE AND CO-LOCATE PRIMARY CARE AND BEHAVIORAL HEALTH (INCLUDING MEDICATION MANAGEMENT, MENTAL HEALTH THERAPY, AND SUBSTANCE USE DISORDER SCREENING).- INCREASE COMPLIANCE WITH ANNUAL WELLNESS VISITS FOR CURRENT PATIENT PANEL TO ENSURE STANDARDIZED BEHAVIORAL HEALTH SCREENINGS ARE COMPLETED.- INCREASE COMPLIANCE WITH STANDARDIZED BEHAVIORAL HEALTH SCREENINGS (AT WELLNESS VISITS FOR CURRENT CLINIC PATIENT PANELS AND FOR ACUTE CARE AND EMERGENCY VISITS) AND ENSURE PATIENTS ARE REFERRED TO NEEDED SERVICES.- INCREASE THE NUMBER OF ASTRIA EMPLOYED MEDICATION ASSISTED THERAPY (MAT) PROVIDERS.- COORDINATE WITH YAKAMA NATION PRIMARY CARE AND BEHAVIORAL HEALTH/SUBSTANCE ABUSE DISORDER PROVIDERS.- EXPAND THE INPATIENT BEHAVIORAL HEALTH PROGRAM AT ASTRIA TOPPENISH HOSPITAL.(2) IMPROVE ACCESS TO CARE (PRIMARY AND SPECIALTY) FOR PREVENTION, SCREENING, AND TREATMENT OF CHRONIC DISEASES, DENTAL CARE, AND CARE TRANSITIONS AND CARE COORDINATION.- DEVELOP A COMPREHENSIVE PROGRAM FOR DISCHARGE PLANNING FOCUSED ON CONNECTING HIGH-RISK PATIENTS TO PRIMARY CARE PROVIDERS AND COMMUNITY RESOURCES.- IMPROVE SYSTEM FOR IDENTIFICATION AND TREATMENT OF CHRONIC DISEASES BY CONTINUING/EXPANDING STRATEGIES DEVELOPED THROUGH GREATER COLUMBIA ACH.- EXPAND HOME MONITORING PROGRAM FOR PATIENTS WITH HIGH BLOOD PRESSURE.- PILOT EMBEDDING COMMUNITY HEALTH WORKERS WITHIN PRIMARY CARE TO SUPPORT CARE TRANSITIONS AND CARE COORDINATION.- PARTICIPATE IN COMMUNITY OUTREACH EVENTS TO IDENTIFY COMMUNITY MEMBERS AT RISK OF CHRONIC DISEASES AND CONNECT THEM TO PRIMARY CARE PROVIDERS.- IMPLEMENT INTEGRATED DENTAL SERVICES IN RURAL HEALTH CLINICS.- DEVELOP RELATIONSHIPS WITH LARGE AGRICULTURAL EMPLOYERS TO PROVIDE PREVENTATIVE HEALTH SERVICES TO EMPLOYEES WHO MAY NOT BE ABLE TO ACCESS CARE DURING TRADITIONAL HOURS.- ESTABLISH A 27-STATION OUTPATIENT DIALYSIS FACILITY FOR END-STAGE RENAL DISEASE.- RECRUIT ADDITIONAL PRIMARY CARE AND SPECIALTY PROVIDERS TO THE COMMUNITY.- EXPAND ENDOSCOPY AND SURGICAL SERVICES THROUGH ASTRIA TOPPENISH HOSPITAL.(3) ADDRESSING SOCIAL DETERMINANTS OF HEALTH INCLUDING HOUSING AFFORDABILITY, ACCESS, AND QUALITY; FOOD INSECURITY; PROVIDE TRAINING AND INCREASE EFFORTS TO IMPROVE HEALTH EQUITY; CARE TRANSITIONS AND CARE COORDINATION.- DEVELOP A LIST OF COMMUNITY RESOURCES ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND ESTABLISH FORMAL SYSTEM FOR COLLABORATION- ESTABLISH A SYSTEM FOR SCREENING PATIENTS FOR ASSISTANCE WITH SOCIAL DETERMINANTS OF HEALTH (SDOH) AND ESTABLISH A COMMUNITY REFERRAL SYSTEM.- PARTNER WITH THE COMMUNITY TO INCREASE AFFORDABLE HOUSING OPTIONS- CONDUCT A HEALTH EQUITY ASSESSMENT, IDENTIFY SPECIFIC HEALTH EQUITY ISSUES WITHIN THE ASTRIA HEALTH SYSTEM, IDENTIFY TRAINING NEEDS AND IMPLEMENT HEALTH EQUITY TRAINING ACROSS THE SYSTEM. SUNNYSIDE COMMUNITY HOSPITAL PART V, SECTION B, LINE 13H: HARDSHIP AND DEBT RATIO SUNNYSIDE COMMUNITY HOSPITAL PART V, SECTION B, LINE 15E: DESCRIBED THE APPEALS PROCESS SHOULD IT BE DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. SUNNYSIDE COMMUNITY HOSPITAL PART V, SECTION B, LINE 16J: AS PART OF THE INTAKE OR DISCHARGE PROCESS, PATIENTS ARE OFFERED A PATIENT INFORMATION PACKET THAT OUTLINES PAYMENT PLAN OPTIONS AND FINANCIAL ASSISTANCE POLICY INFORMATION INCLUDING THE PLAIN LANGUAGE SUMMARY. THE POLICY WILL BE INTERPRETED FOR OTHER NON-ENGLISH SPEAKING OR LIMITED ENGLISH SPEAKING OR OTHER PATIENTS WHO ARE UNABLE TO READ OR UNDERSTAND THE WRITTEN POLICY OR ORAL EXPLANATION.PART V, SECTION B, LINES 16A - 16C: THE CHARITY CARE POLICY, APPLICATION, AND PLAIN LANGUAGE OF APPLICATION CAN BE FOUND AT THE FOLLOWING URL: WWW.ASTRIA.HEALTH/CHARITY-CARE/ PART V, SECTION B, LINE 7A: WWW.ASTRIA.HEALTH/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, SECTION B, LINE 10A: WWW.ASTRIA.HEALTH/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 9 1 - GRANDVIEW MEDICAL CENTER 208 N EUCLID GRANDVIEW WA 98930 RURAL HEALTH CLINIC 2 - LINCOLN AVENUE FAMILY MEDICINE 803 E LINCOLN SUNNYSIDE WA 98944 RURAL HEALTH CLINIC 3 - VALLEY INTERNAL MEDICINE 2925 ALLEN RD SUNNYSIDE WA 98944 RURAL HEALTH CLINIC 4 - SUNNYSIDE PEDIATRICS 812 MILLER AVE STE C SUNNYSIDE WA 98944 RURAL HEALTH CLINIC 5 - JOHN HUGHES STUDENT HEALTH CENTER 1801 EAST EDISON AVE SUNNYSIDE WA 98944 RURAL HEALTH CLINIC 6 - VALLEY REGIONAL RHC V 2705 E LINCOLN AVE SUNNYSIDE WA 98944 RURAL HEALTH CLINIC 7 - MEDICAL PLAZA IN PROSSER 355 CHARDONNAY AVE PROSSER WA 99350 RURAL HEALTH CLINIC 8 - BIRCH STREET MEDICAL CENTER II 222 E 2ND ST GRANDVIEW WA 98930 RURAL HEALTH CLINIC 9 - ASTRIA HEALTH CENTER 1812 E EDISON AVE SUNNYSIDE WA 98944 RURAL HEALTH CLINIC PART I, LINE 7: THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT REPORTED IN THE TABLE DERIVED FROM WORKSHEETS 1 AND 2 FROM THE IRS INSTRUCTIONS FOR SCHEDULE H.BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN: $10,777,901.DUE TO COMING OUT OF BANKRUPTCY AND TURN OVER, THE HOSPITAL WAS NOT ABLE TO CAPTURE DOLLAR AMOUNTS ASSOCIATED WITH ALL OF ITS COMMUNITY BENEFIT ACTIVITIES CONDUCTED IN 2023.PART I, LINE 7E:ASTRIA SUNNYSIDE HOSPITAL PHARMACY AND EMERGENCY DEPARTMENT TEAMED UP TO PROVIDE TRAINING ON NALOXONE USE AND STORAGE TO SUNNYSIDE POLICE OFFICERS, A DIRECT ANSWER TO INFORMATION IN OUR CHNA STATING THAT OPIOID DEATHS HAVE RISEN 344% IN OUR COMMUNITIES BETWEEN THE PERIODS OF 2002-2004 AND 2018-2020. ASH ALSO ISSUED PRESCRIPTIONS TO ALL SSPD OFFICERS FOR NALOXONEAND FILLED THEMAND PROVIDED A REFILL.ASTRIA SUNNYSIDE HOSPITAL REPURPOSED A FORMER MEDICATION DISPOSAL BOX INTO A COMMUNITY SHARPS DISPOSAL BOX. THE LOCKED AND SECURE BOX WAS REPAINTED BRIGHT RED AND VINYL GRAPHICS APPLIED TO LET THE COMMUNITY KNOW THAT THIS WAS A SAFE AND CONVENIENT WAY TO DISPOSE OF SYRINGES, RAZOR BLADES, NEEDLE TIPS AND LANCETS TO HELP PROTECT AGAINST ACCIDENTAL INJURY AND REDUCE THE SPREAD OF BLOODBORNE PATHOGENS.IN 2023 THE CANCER CENTER OPENED ITS HEALING GARDEN. THE PURPOSE OF THE GARDEN IS TO PROVIDE A SPACE FOR CANCER PATIENTS TO GET OUTDOORS AND ENJOY NATURE.ASTRIA SUNNYSIDE HOSPITAL COLLABORATES WITH THE AMERICAN RED CROSS TO PROMOTE BLOOD DRIVES IN SUNNYSIDE BY PROMOTING THEM TO STAFF AND THE COMMUNITY THROUGH FLIERS AND SOCIAL MEDIA POSTS. THERE WERE 5 BLOOD DRIVES HELD IN 2023 AT THE FORMER UNITED METHODIST CHURCH, AND 145 UNITS WERE COLLECTED.ASTRIA SUNNYSIDE HOSPITAL, THROUGH ITS PARENT ASTRIA HEALTH, PARTNERED WITH ESD 105 TO PROVIDE STUDENTS ACCESS TO MENTAL HEALTH CARE WHEN NEEDED, WITHOUT LONG WAITS TO SEE A HEALTHCARE PROFESSIONAL. TO ASSURE NECESSARY COVERAGE, THE PARTNERSHIP CREATED A PROGRAM THAT MEETS THE NEEDS OF ALL STUDENTS BY PROVIDING SUPPORT TO LICENSED CLINICAL SOCIAL WORKERS WHOSE PATIENTS REQUIRE MEDICATION INTERVENTION. ESD 105'S SERVICE AREA COVERS 25 SCHOOL DISTRICTS.ASTRIA SUNNYSIDE HOSPITAL SPONSORED THE MISS SUNNYSIDE COURT'S BRUNCH WITH SANTA EVENT, HELD DECEMBER 19, 2023.ASTRIA SUNNYSIDE HOSPITAL SPONSORED THE LIGHTED FARM IMPLEMENT PARADE, A WIDELY ATTENDED COMMUNITY EVENT.ASTRIA SUNNYSIDE HOSPITAL PROVIDED SPORTS PHYSICALS AT A $10 FLAT RATE TO THE COMMUNITY.PART I, LINE 7F:WE PROVIDE CLINICAL ROTATIONS FOR RADIOLOGY STUDENTS AND NURSING STUDENTS. CLINICAL ROTATIONS IN NURSING EDUCATION IS TO PROVIDE NURSING STUDENTS WITH HANDS-ON EXPERIENCE AND EXPOSURE TO VARIOUS HEALTHCARE SETTINGS TO DEVELOP THEIR CLINICAL SKILLS, CRITICAL THINKING AND PATIENT CARE ABILITIES. PART III, LINE 2: THE HOSPITAL USED THE COST TO CHARGE RATIO OF PATIENT CARE TO DETERMINE THE COST OF BAD DEBT EXPENSE. PART III, LINE 3: THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. WITH THE COMMUNITY SERVED BY ASTRIA SUNNYSIDE HOSPITAL IT IS VERY LIKELY THAT THERE IS A COMPONENT OF BAD DEBT THAT IS ATTRIBUTABLE TO SUCH. PART III, LINE 4: SEE PAGE 10 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. PART III, LINE 9B: ADMITTING AND TWO SELF-PAY COUNSELORS VISIT WITH PATIENTS BEFORE THEY ARE DISCHARGED TO DETERMINE IF THE PATIENT QUALIFIES FOR CHARITY CARE BASED ON THEIR FINANCIAL POSITION AND THE FEDERAL POVERTY GUIDELINES. THE APPLICATIONS ARE REVIEWED AND EVALUATED FOR CHARITY CARE STATUS AND WRITTEN OFF WHEN APPROPRIATE. PART VI, LINE 2: THE HOSPITAL BOARD ANNUALLY REVIEWS COMMUNITY DEMOGRAPHICS, PATIENT ORIGINS, CURRENT SERVICES AND FUTURE NEEDS. FROM THIS REVIEW, THE BOARD CONTINUALLY ASSESSES THE COMMUNITY NEEDS. MANAGEMENT, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. PART VI, LINE 3: THE INFORMATION IS DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. A BROCHURE IS PLACED IN PUBLIC AREAS OF THE HOSPITAL, AS WELL AS INCLUDED IN ALL FORMAL ADMISSION PACKETS TO PATIENTS. PATIENT ACCOUNT REPRESENTATIVES HAND OUT THE INFORMATION DURING PATIENT CONSULTS AS WELL. SIGNS ARE POSTED, IN ENGLISH AND IN SPANISH, IN ALL REGISTRATION AND WAITING AREAS, AND THE BUSINESS OFFICE. THE SIGN STATES: "ASTRIA SUNNYSIDE HOSPITAL PROVIDES CHARITY CARE TO PERSONS MEETING MEDICAL INDIGENT CRITERIA. CHARGES MAY BE WAIVED OR REDUCED IF ELIGIBILITY FOR CHARITY CARE IS DETERMINED." THE INFORMATION IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE AND INCLUDED WITH EVERY PATIENT ACCOUNT STATEMENT. PART V, SECTION B, LINE 16 OUTLINES ADDITIONAL WAYS THE ORGANIZATION PUBLICIZES ITS FINANCIAL ASSISTANCE INFORMATION. THE LATEST CHARITY CARE POLICY IS AVAILABLE ON OUR WEBSITE. IT IS UPDATED ANNUALLY WITH NEW POVERTY GUIDELINES. PART VI, LINE 4: SUNNYSIDE, GRANDVIEW AND THE REST OF THE LOWER YAKIMA VALLEY IS A CULTURALLY DIVERSE REGION OF NEARLY 44,000 PEOPLE LIVING BETWEEN THE CITY OF YAKIMA ON THE WEST AND TRI-CITIES, WASHINGTON ON THE EAST. RESIDENTS OF THIS AREA ARE SIGNIFICANTLY YOUNGER THAN RESIDENTS OF YAKIMA COUNTY AND WASHINGTON STATE, WITH APPROXIMATELY 35% BEING UNDER THE AGE OF 18 COMPARED TO JUST OVER 22% STATEWIDE. APPROXIMATELY 10% OF RESIDENTS ARE 65 OR OLDER. THE HISPANIC POPULATION MAKES UP 81.7% OF THE POPULATION AND WHITE NON-HISPANIC 50.8% OF THE POPULATION. MANY RESIDENTS IN THE COMMUNITY EXPERIENCE POVERTY, FOOD INSECURITY, LACK OF TRANSPORTATION, AND LIMITED ACCESS TO AFFORDABLE HOUSING. THE COMMUNITY HAS A MEDIAN HOUSEHOLD INCOME OF $49,598 AND APPROXIMATELY 16.6% OF RESIDENTS HAVE INCOMES BELOW FEDERAL POVERTY GUIDELINES. PART VI, LINE 5: THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF THE COMMUNITY FROM THE MEDICAL SECTOR TO BUSINESS OWNERS TO UNIVERSITY STAFF. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS.MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED AND INTERESTED MEDICAL PROVIDERS WITH ACTIVE LICENSURE IN THE COMMUNITIES WE SERVE. THE HOSPITAL ENCOURAGES PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER-EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY.AS A NON-PROFIT CORPORATION, SURPLUS FUNDS ARE REINVESTED INTO BUILDING AND EQUIPMENT UPGRADES AND COMMUNITY HEALTH EDUCATION TO MAINTAIN THE HIGHEST QUALITY HEALTHCARE FOR OUR COMMUNITY. SURPLUS FUNDS ARE ALSO APPLIED TO ONGOING PROFESSIONAL EDUCATION AMONG OUR CLINICAL STAFF TO REMAIN CURRENT IN THE BEST PRACTICES OF HEALTHCARE. THIS ALLOWS THEHOSPITAL TO FOCUS ON WHAT IS IMPORTANT - MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITIES WE SERVE IN AN ECONOMICALLY VIABLE FASHION.THE HOSPITAL'S CHARITY CARE PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE FINANCIAL RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTHCARE THEY RECEIVE. THE CHARITY CARE PROGRAM IS DESIGNED TO ENSURE THAT THE YAKIMA VALLEY IN ITS ENTIRETY HAS ACCESS TO NECESSARY HEALTHCARE SERVICES. THE HOSPITAL ACCEPTS ALL PATIENTS IN NEED OF MEDICALASSISTANCE, REGARDLESS OF ABILITY TO PAY.THE HOSPITAL OPERATES A FULLY STAFFED 24-HOUR EMERGENCY ROOM, AVAILABLE TO THE PUBLIC REGARDLESS OF ABILITY TO PAY.IN ADDITION TO THE CHARITY CARE PROGRAM, THE HOSPITAL PROVIDES OR PARTICIPATES IN SEVERAL OTHER PROGRAMS WHICH CONTRIBUTE TO ITS CHARITABLE MISSION. THIS INCLUDES HOSTING AN ANNUAL HEALTH FAIR WITH FREE ACCESS TO HEALTHCARE PROFESSIONALS, FREE SCREENINGS AND A WEALTH OF HEALTH AND WELLNESS INFORMATION MADE AVAILABLE TO THE PUBLIC, AS WELL AS PUTTING ON A COMMUNITY BABY SHOWER FOR PREGNANT PATIENTS WITHIN THE COMMUNITY. PART VI, LINE 6: THE HOSPITAL, ALONG WITH ASTRIA TOPPENISH HOSPITAL, IS PART OF THE ASTRIA HEALTH SYSTEM, HEADQUARTERED IN THE HEART OF YAKIMA VALLEY IN THE STATE OF WASHINGTON. THIS NON-PROFIT HEALTHCARE SYSTEM BASED IN EASTERN WASHINGTON IS COMMITTED TO INVESTING IN A CONTINUUM OF CARE FOR THE PEOPLE WHO LIVE AND WORK THROUGHOUT EASTERN WASHINGTON AND BUILD SUSTAINABLE HEALTHCARE ORGANIZATIONS THAT IMPROVE HEALTH IN THE COMMUNITIES WE SERVE.ASTRIA SUNNYSIDE HOSPITAL IS LOCATED IN SUNNYSIDE WASHINGTON AND ASTRIA TOPPENISH HOSPITAL IS LOCATED IN TOPPENISH WASHINGTON. THE SERVICE AREA IS DEFINED AS YAKIMA COUNTY AND THE COMMUNITIES OF PROSSER WHICH IS IN BENTON COUNTY AND ELLENSBURG WHICH IS IN KITTITAS COUNTY.ASTRIA SUNNYSIDE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND ALSO OPERATES A NUMBER OF RURAL HEALTH CLINICS. ASTRIA TOPPENISH HOSPITAL IS A COMMUNITY HOSPITAL AND CARES FOR THE UNIQUE NEEDS OF THE TOPPENISH AREA, INCLUDING CARING FOR PEOPLE LIVING AND WORKING ON THE YAKAMA NATION. 0 0 0 0 0 0 0 0 0 BRIAN GIBBONS CEO 0 481943 0 355666 0 4168 0 13200 0 43834 0 898811 0 0 DAVID SHOEMAKER PHYSICIAN, CHIEF OF STAFF 655647 0 189130 0 6655 0 13200 0 16008 0 880640 0 0 0 ERNESTO DIZON MD PHYSICIAN 674460 0 128349 0 3165 0 13200 0 43447 0 862621 0 0 0 PETER GRUNERT MD PHYSICIAN 791168 0 0 0 660 0 13200 0 12854 0 817882 0 0 0 MAXWELL OWENS CFO 0 374726 0 271708 0 6397 0 13200 0 16974 0 683005 0 0 MANUEL YBANEZ MD PHYSICIAN 594405 0 38250 0 4691 0 13200 0 11231 0 661777 0 0 0 BRAD WARD MD PHYSICIAN 606103 0 0 0 4356 0 13200 0 36978 0 660637 0 0 0 WINNIE ADAMS CNO 0 198635 0 19713 0 1750 0 7434 0 42140 0 269672 0 0 PART I, LINE 3: THE ORGANIZATION CONTRACTS WITH ASTRIA HEALTH FOR MANAGEMENT SERVICES. ASTRIA HEALTH DETERMINES THE CEO, CFO, AND CNO SALARY. ASTRIA HEALTH ESTABLISHES SALARIES AT THE TIME OF HIRE AND PERIODICALLY REVIEWS THEM THEREAFTER. TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY-RELATED EXPERIENCE B) PREVAILING CEO, CFO & CNO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR BUSINESSES OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA; AND C) ASTRIA HEALTH'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY ASTRIA HEALTH'S BOARD OR A SUBCOMMITTEE THEREOF. IN ADDITION TO BASE SALARY, THE CEO, CFO AND CNO MAY BE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON PERFORMANCE PARAMETERS ESTABLISHED BY ASTRIA HEALTH AND APPROVED BY THE ASTRIA HEALTH BOARD. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ASTRIA HEALTH (AH). AH, AS THE PARENT AND SYSTEM ENTITY, PROVIDES THE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT NON-PROFIT CORPORATE ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING MANAGEMENT OF: - EXECUTIVE ACTIVITIES - INFORMATION SYSTEMS - FINANCIAL OPERATIONS - HEALTH INFORMATION AND RECORDS - SCHEDULING AND REFERRALS - HUMAN RESOURCES - MATERIALS AND SUPPLIES - MEDICAL STAFF AND PHYSICIANS SERVICES - QUALITY RESOURCES - RISK MANAGEMENT - MARKETING AND COMMUNITY RELATIONS - SHARED SERVICES DIRECTORS FOR LABORATORY THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY AH: BRIAN GIBBONS $893,048 (COMPENSATION FOR SERVICES AS AN OFFICER OF AH AND RELATED TAX-EXEMPT ENTITIES) MAXWELL OWENS $682,522 (COMPENSATION FOR SERVICES AS AN OFFICER OF AH AND RELATED TAX-EXEMPT ENTITIES) WINNIE ADAMS - $264,509 FORM 990, PART VI, SECTION A, LINE 6 ASTRIA HEALTH IS THE SOLE MEMBER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A ASTRIA HEALTH AS THE SOLE MEMBER OF THE HOSPITAL HAS THE AUTHORITY TO ELECT THE HOSPITAL'S BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B ASTRIA HEALTH AS THE SOLE MEMBER OF THE HOSPITAL HAS THE AUTHORITY TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY AND TO RECEIVE THE HOSPITAL'S NET ASSETS UPON THE HOSPITAL'S DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO ASTRIA HEALTH'S CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER PRIOR TO APPROVAL OF THE 990. A DRAFT IS ALSO DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO AUTHORIZES THE PREPARER TO FINALIZE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD FILLS OUT A CONFLICT OF INTEREST FORM DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR THROUGH SELF DISCLOSURE IN THE INTERIM. IF A POTENTIAL CONFLICT ARISES, THE AFFECTED PERSON SHALL FULLY DISCLOSE THE NATURE OF THE INTEREST AND WITHDRAW FROM DISCUSSION AND VOTING ON THE MATTER. ANY TRANSACTION OR VOTE INVOLVING A POTENTIAL CONFLICT OF INTEREST SHALL BE APPROVED ONLY WHEN A MAJORITY OF DISINTERESTED DIRECTORS DETERMINE THAT IT IS IN THE BEST INTEREST OF THE HOSPITAL TO DO SO. THE HOSPITAL HAS A COMPLIANCE AND MONITORING POLICY THAT IS ENFORCED BY THE CEO. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - THE CEO IS EMPLOYED AND COMPENSATED THROUGH ASTRIA HEALTH, A RELATED ORGANIZATION. THE SALARY IS ESTABLISHED AT THE TIME OF HIRE, AND PERIODICALLY THEREAFTER, TAKING THE FOLLOWING FACTORS INTO ACCOUNT: A) QUALIFICATIONS OF THE CANDIDATE, INCLUDING NUMBER OF YEARS OF DIRECTLY RELATED EXPERIENCE. B) PREVAILING CEO COMPENSATION RATES, AS EVIDENCED BY SALARY SURVEY DATA FOR HOSPITALS OF SIMILAR SIZE AND WITHIN THE RELEVANT GEOGRAPHIC AREA. C) ASTRIA HEALTH'S ABILITY AND WILLINGNESS TO PAY, AS AGREED BY THE HOSPITAL BOARD OR A SUBCOMMITTEE THEREOF. THE CEO'S COMPENSATION WAS LAST REVIEWED IN 2023. LINE 15B - THE CFO'S AND CNO'S COMPENSATION IS DETERMINED IN THE SAME MANNER AS THE CEO'S. THE CFO'S COMPENSATION WAS LAST REVIEWED IN 2023. THE CNO'S COMPENSATION WAS LAST REVIEWED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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