Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Description of Classes of Members or Stockholders | Form 990, Part VI, Line 6 | THE ORGANIZATION HAS 1 CORPORATE MEMBER, COMMUNITY HEALTH NETWORK OF WASHINGTON ("CHNW"), A 501(c)(4) TAX EXEMPT ENTITY. |
| Description of Classes of Persons and the Nature of Their Rights | Form 990, Part VI, Line 7a | THE BOARD OF DIRECTORS OF THE SOLE CORPORATE MEMBER, CHNW, ELECTS THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD OF DIRECTORS MUST MEET THE QUALIFICATIONS TO BE A CHNW BOARD MEMBER. DURING 2010, CHNW AND THE ORGANIZATION HAD IDENTICAL BOARDS OF DIRECTORS. |
| Describe the Process used by Management &/or Governing Body to Review 990 | Form 990, Part VI, Line 11 | THE 990 IS REVIEWED BY THE ASSISTANT CONTROLLER, CONTROLLER, CHIEF FINANCIAL OFFICER, VICE PRESIDENT AND GENERAL COUNSEL, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FINANCIAL OFFICER THEN PRESENTS IT TO THE FINANCIAL COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW AND APPROVALS BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. IT IS RECORDED IN THE BOARD MINUTES; RECORDING BOARD ACTION TO APPROVE FORM 990. |
| Description of Process to Monitor Transactions for Conflicts of Interest | Form 990, Part VI, Line 12c | ALL DIRECTORS, OFFICERS, AND SENIOR EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. WITH RESPECT TO BOARD MEMBERS, POTENTIAL CONFLICTS ARE DISCLOSED PRIOR TO DELIBERATIONS; IF AN ACTUAL CONFLICTS EXISTS, THE INDIVIDUAL WITH THE CONFLICT WILL NOT PARTICIPATE AND IS ASKED TO LEAVE THE MEETING DURING FINAL DELIBERATIONS AND VOTE. EMPLOYEES ARE GOVERNED BY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; ACTUAL OR POTENTIAL CONFLICTS MUST BE DISCLOSED TO THE HUMAN RESOURCES DEPARTMENT OR CORPORATE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER, IN COOPERATION WITH HUMAN RESOURCES, WILL REVIEW THE CONFLICT AND ADVISE THE EMPLOYEE WITH A POTENTIAL CONFLICT CONCERNING ANY LIMITATIONS THEY MUST OBSERVE IN REGARDS TO THE CONFLICT OF INTEREST. |
| Offices & Positions for Which Process was Used, & Year Process was Begun | Form 990, Part VI, Line 15A | AT LEAST ANNUALLY, THE CHPW HUMAN RESOURCES DEPARTMENT REVIEWS COMPENSATION OF ALL EMPLOYEES (INCLUDING EMPLOYED OFFICERS AND KEY EMPLOYEES). THE CHPW HUMAN RESOURCES DEPARTMENT UTILIZES SEVERAL INDEPENDENT THIRD PARTY COMPENSATION SURVEYS TO MAKE RECOMMENDATIONS ABOUT EMPLOYED OFFICER AND KEY EMPLOYEE COMPENSATION. UTILIZING THAT INFORMATION, THE CHPW CEO SETS THE COMPENSATION FOR EMPLOYED OFFICERS AND KEY EMPLOYEES. THE CHPW CEO COMPENSATION IS SET BY THE CHPW BOARD OF DIRECTORS BASED UPON INDEPENDENT THIRD-PARTY COMPENSATION INFORMATION AND PROFESSIONAL OPINION. THE DELIBERATIONS AND APPROVAL OF CEO COMPENSATION ARE RECORDED IN THE BOARD MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2010. |
| Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public | Form 990, Part VI, Line 19 | COPIES OF GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST MADE TO THE CORPORATE OFFICES AT 720 OLIVE WAY, SUITE 300 SEATTLE, WA 98101 OR BY FAXING A REQUEST TO (206) 521-8834. ALSO, THE PLAN FINANCIAL STATEMENTS ARE POSTED ON THE OIC WEBSITE. |
| Hours Devoted to Related Organizations | Form 990, Part VII | EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH PLAN OF WASHINGTON ("CHPW", WHICH IS AN AFFILIATE OF THE ORGANIZATION). THE OFFICERS, KEY EMPLOYEES, AND FIVE HIGHEST PAID EMPLOYEES REPORTED IN PART VII DEVOTE A COMBINED AVERAGE TOTAL OF 40 HOURS PER WEEK TO CHNW AND CHPW. |
| Other Changes in Net Assets | Form 990, Part XI, Line 5 | Unrealized gains on investments = 1,752,534 |
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