TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Scott Wagner...................................................................... Director, Chairman	2.00 .................	X	X			0	0
(2) Dave Hargreaves...................................................................... Director, Vice-Chairman	2.00 .................	X	X			0	0
(3) Bill Feldmann MD...................................................................... Director, Treasurer	2.00 .................	X	X			0	0
(4) Buffy Alegria...................................................................... Director, Secretary	2.00 .................	X	X			0	0
(5) Bruce Heiser...................................................................... Director	2.00 .................	X				0	0
(6) Maribel Jimenez...................................................................... Director	2.00 .................	X				0	0
(7) Rich Martinez...................................................................... Director	2.00 .................	X				0	0
(8) Sonia Rodriguez True...................................................................... Director	2.00 .................	X				0	0
(9) Steve Rupp MD...................................................................... Director	2.00 .................	X				0	0
(10) Gail Weaver...................................................................... Director	2.00 .................	X				0	0
(11) Jim Young...................................................................... Director	2.00 .................	X				0	0
(12) Russell Myers...................................................................... President/CEO	40.00 .................		X			512,197	71,160
(13) Tim Reed...................................................................... Vice President/CFO	40.00 .................		X			292,818	65,584
(14) Diane Patterson...................................................................... Vice President, CCO	40.00 .................			X		264,011	61,171
(15) Matthew Kollman...................................................................... MP/COO	40.00 .................			X		190,025	53,521
(16) Vu Le...................................................................... Physician - MP	40.00 .................				X	1,018,234	38,757
(17) Rick Gross...................................................................... Physician - MP	40.00 .................				X	529,634	61,212

(A) Name and business address	(B) Description of services	(C) Compensation
Orthopedics Northwest 1211 N 16th Ave Yakima,WA98902	Medical and Health Care	16,546,205
Yakima Heart Center Inc PS 406 S 30th Ave Suite 201 Yakima,WA98902	Medical and Health Care	11,101,164
Emergency Associates of Yakima 2811 Tieton Drive Yakima,WA98902	Medical and Health Care	10,566,015
Yakima Urology Associates PPLC 2500 Racquet Lane Yakima,WA98902	Medical and Health Care	5,223,657
Cerner Corporation PO Box 959167 St Louis,MO63195	Contractor	4,722,611
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 117

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

0 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

0 %

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

0 %

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization Yakima Valley Memorial Hospital Association

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization Yakima Valley Memorial Hospital Association		Employer identification number 91-0567263

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization Yakima Valley Memorial Hospital Association			Employer identification number 91-0567263
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures). Click to see attachment

B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................	46,629	180,464
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................	60,000	113,574
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................	106,629	294,038
d	Other exempt purpose expenditures ........................................................................	478,546,936	1,685,581,835
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................	478,653,565	1,685,875,873
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000	1,000,000
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................	250,000	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................		Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	154,766	275,782	28,247	294,038	752,833

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures	108,173	163,134	175,480	180,464	627,251

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

60,000

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

46,629

Total. Add lines 1c through 1i ....................................................................................................

106,629

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
II-A A	Yakima Valley Memorial Hospital Association, EIN 91-0567263, 2811 Tieton Drive, Yakima, WA 98902. Non-electing member. 46,629 Grassroots Lobbying Expenditures 60,000 Direct Lobbying Expenditures. Excess Lobbying Expenditures 0. Yakima Valley Memorial Hospital Association pays membership dues to Washington State Hospital Association, a portion of which was used for legislative and lobbying activities. Yakima Valley Memorial Hospital Association also pays membership dues to other professional health care organizations, a portion of which may be used for legislative and lobbying activities.
II-A A continued	Virginia Mason Medical Center, EIN 91-0565539, 1100 Ninth Avenue, Seattle, WA 98101. Electing member. Grassroots Lobbying Expenditures 133,835 Direct Lobbying Expenditures 53,574. Excess Lobbying Expenditures 0. Tax year ending December 31, 1998 was the first year in which Virginia Mason Medical Center made the election under Section 501h. The election was not revoked before the start of the tax year ending December 31, 2018.
II-A A continued	Virginia Mason Institute, EIN 26-3763656, 1100 Ninth Avenue, Seattle, WA 98101. Non-electing member. 0 Lobbying Expenditures, 0 Excess Lobbying Expenditures.
II-A A continued	Virginia Mason Health System, EIN 91-1351110, 1100 Ninth Avenue, Seattle, WA 98101. Non-electing member. 0 Lobbying Expenditures. Excess Lobbying Expenditures 0
II-A A continued	Benaroya Research Institute at Virginia Mason, EIN 91-0653422, 1201 Ninth Avenue, Seattle, WA 98101. Non-electing member. 0 Lobbying Expenditures. Excess Lobbying Expenditures 0.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	13,761,892		13,761,892
b	Buildings ....	93,365,510	10,871,660	82,493,850
c	Leasehold improvements	6,471,462	1,708,564	4,762,898
d	Equipment ....	137,456,781	45,376,003	92,080,778
e	Other .....	14,516,754	1,054,838	13,461,916
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				206,561,334

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) Financial derivatives and other financial products
(B) Closely-held equity interests
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Federal income taxes
other liabilities
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

X 2

U.S. GAAP require management to evaluate tax positions taken by Memorial and recognize a tax liability or asset if Memorial has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. Management has analyzed tax positions taken by Memorial and concluded that as of December 31, 2018 and 2017, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or asset or disclosure in the consolidated financial statements. Memorial is subject to routine audits by taxing jurisdictions however, there are currently no audits for any tax periods in progress. Memorials management believes it is no longer subject to income tax examinations for years prior to 2015.

Schedule D (Form 990) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			9,117,503		9,117,503	1.900 %
b	Medicaid (from Worksheet 3, column a) . . . . .			113,100,356	84,453,573	28,646,783	5.980 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			122,217,859	84,453,573	37,764,286	7.880 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	8	15,709	2,708,268	350,969	2,357,299	0.490 %
f	Health professions education (from Worksheet 5) . . .	6	776	7,690,885		7,690,885	1.610 %
g	Subsidized health services (from Worksheet 6) . . . .	3	6,151	11,042,278	7,716,907	3,325,371	0.690 %
h	Research (from Worksheet 7) .	1	125	501,808		501,808	0.100 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3		402,014		402,014	0.080 %
j	Total. Other Benefits . .	21	22,761	22,345,253	8,067,876	14,277,377	2.970 %
k	Total. Add lines 7d and 7j .	21	22,761	144,563,112	92,521,449	52,041,663	10.850 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1		152,940		152,940	0.030 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1		124,351	500	123,851	0.030 %
8	Workforce development	1	15	68,723		68,723	0.010 %
9	Other
10	Total	3	15	346,014	500	345,514	0.070 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,346,443

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

113,575,820

Enter Medicare allowable costs of care relating to payments on line 5.....

116,543,514

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-2,967,694

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	Yakima Valley Memorial Hospital Association 2811 Tieton Drive Yakima,WA98902 yakimamemorial.org 58	X	X	X	X	A

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): yakimamemorial.org/about-us-community-benefits.asp

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): yakimamemorial.org/about-us-community-benefits.asp

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 0000000300.000000000000% and FPG family income limit for eligibility for discounted care of 0000000300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

yakimamemorial.org

The FAP application form was widely available on a website (list url):

yakimamemorial.org

A plain language summary of the FAP was widely available on a website (list url):
yakimamemorial.org

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Group Yakima Valley Memorial Hospital Association Line Part V, Section B, Line 3j	Memorials 2016 Community Health Needs Assessment was adopted by the Board of Directors on November 29, 2016. The report was made public on the website and printed copies are available at the hospital upon request. The areas of assessment in the 2016 report are demographics social and economic determinants of health including - education, health literacy, unemployment, income poverty, children eligible for free school lunch, food insecurity, housing and transportation affordability, households without a car, disability status, homelessness, safety, crime and violence clinical care including - access to health services, uninsured population, cost barriers to care, clinical preventive services health outcomes including - chronic disease profile, mortality, quality of life leading health indicators including - health behaviors, maternal, infant and child health, reproductive sexual health, mental health, injury and hospitalization physical environment including - air pollution, food environment index, access to locations for physical activity, transportation, drinking water, severe housing problems, toxic chemicals. Additional assessments are conducted on an ongoing basis to track needs. Data sources used are internal, US Census, BRFSS, Health Youth Survey, Department of Health, Cancer Registry and many other public data sources. Disparity gaps were identified when comparing the State of Washington to Yakima County. Furthermore, when data was available, indicators were stratified by age, sex and race ethnicity in order to identify disparities in health outcomes. Memorials actions and progress in addressing the priority areas identified in the previous Community Health Needs Assessment 2013 are identified throughout the 2016 Community Health Needs Assessment in the associated topic sections and identified by the priority area number.
Group Yakima Valley Memorial Hospital Association Line Part V, Section B, Line 5	Input for development of the Community Health Needs Assessment was solicited through an online tool. The internal advisory committee selected the top nine areas of greatest need and through the survey community organizations could provide input on the CHNA. The nine areas of greatest need were access to care health equity - disparities in health care, prevention and outcomes chronic disease prevention and screenings mental health health behaviors - physical inactivity and nutrition adverse childhood experiences homelessness infant mortality and sexually transmitted infections. The survey asked respondents to compare each of the nine priority areas to each other by placing them in order of importance to both them as a community member, as well as to the organization they represent the average ranking was calculated for each answer choice to select the top three priority areas that were of greatest importance to the community we serve. The top three areas were 1 Access to care, final ranked score of 7.46 2 Health Equity, final ranked score of 6.03 and 3 chronic disease prevention and screenings, final ranked score of 5.96. We did not limit responses but sent out the request to take the survey to as many partners in the community as possible and also asked that they forward on to any other partners they felt should be involved. We allowed three weeks for responses. Feedback was received from over 60 organizations spanning different sectors including state, local and tribal health departments health care providers, including specialty services such as mental health community-based organizations, coalitions, and groups representing members of the under-served, low-income and minority populations in the community churches and faith-based organizations businesses the school district community colleges and universities local government and individual health experts within the community. A full list of partners is included in the Community Health Needs Assessment which can be found on Memorials website www.yakimamemorial.org/about-us-community-benefits.asp. The top three priority areas chosen by the community were assigned as primary and secondary priority areas based on hospital resources and ability to address the area of need. Some additional areas of need out of the top nine that did not make the top three were also selected as tertiary priority areas, Memorial committing to focus on these areas by partnering with others in the community working on those issues where possible and providing funding to support those needs when available.
Group Valley Imaging Line Part V, Section B, Line 7d	In addition to being made publicly available on the website, the 2016 Community Health Needs Assessment was shared widely by email and made public through a number of presentations to community-based organizations, coalitions and groups.
Group Yakima Valley Memorial Hospital Association Line Part V, Section B, Line 11	Memorial has outlined how the hospital is addressing the significant needs identified in the most recently conducted Community Health Needs Assessment in the Virginia Mason Memorial Implementation Plan 2017-2019. The implementation plan is a multi-year guide to improving the health status of our community and targets the prioritized areas and gaps in health needs that have been identified. Through the following four-stage approach we will make progress toward improved health and transforming Yakima Plan - Identify priorities for services and community health improvement processes Partner - Identify those who can work together to best meet community needs Do - Design programs and approaches to improve access to high quality health care services Improve - Improve the health outcomes of Yakima County. As a result of the 2016 Community Health Needs Assessment, health priorities were selected and using our four-stage approach we have developed a step-by-step action plan outlined in the implementation plan to address the five priorities and positively influence the health and well-being of the community. The Virginia Mason Memorial Implementation Plan outlines both internal and community-wide objectives and strategies under each of the priority areas as well as specific measurements and targets that will be used to evaluate our progress. The Virginia Mason Memorial Implementation Plan 2017-2019 was adopted by the Memorial Board of Directors on January 31, 2017. One additional area outlined in the implementation plan, which does not fall under a priority area, is the Enviromason Memorial sustainability program. Memorial identified 5 priority areas in the 2016 Community Health Needs Assessment. All five priorities identified in the 2016 Community Health Needs Assessment are being addressed. These priority areas are Access to Care Health Equity-Disparities in Health Care, Prevention and Outcomes Chronic Disease Prevention and Screenings Adverse Childhood Experiences and Infant Mortality. Access to Care Memorial facilitates the education of patients, employees and community members on accessing Washington State Health Benefits Exchange. We are working with partners as part of the Greater Columbia Accountable Community of Health to explore development of a regional health improvement collaborative and strategy. We have instituted a number of internal initiatives to improve access to primary care and specialty clinics, as well as reduce wait time. Memorials CEO has spearheaded a medical leadership work-group with other hospital and federal qualified health center leaders. The objectives of this work-group are to explore area capacity challenges and common areas of interest and concern, and identify possible coordination-collaboration efforts to create positive Yakima Health outcomes. We partner with, and financially support local community colleges and health profession education programs. Memorial mentors and trains local health professionals from college programs across the county and state on site. This allows students to practice in their respective field of study as required to complete their degree and sit for associated exams. After completion of training and course work each health professional is ready for the workforce and to fill much needed vacancies within the community. Memorial also provides a number of opportunities for continuing medical education programming each year to serve medical professionals across the community, allowing them to renew licenses and continue to practice in Yakima County. Health Equity - Disparities in Health Care, Prevention and Outcomes Memorial is working on initiatives to improve the collection of demographic data e.g. race, ethnicity and preferred language. We developed a cultural competency action plan to better serve our diverse community and have taken the American Hospital Associations Health Equity Pledge with the goal of investigating and developing strategies to improve health disparities for 30-day hospital readmission. We have set interpretation targets to ensure that by the end of 2019 all of our interpreter staff will be Alta-State Certified furthermore, we utilize on-demand video remote interpretation to determine feasibility of providing that service across the family of services. Chronic Disease Prevention and Screenings Memorial has established community education and prevention programs for the top four disease states identified in the Community Health Needs Assessment. They are Cardiovascular Disease, Cancer, Diabetes and Obesity. These community education and prevention classes are all offered in both Spanish and English and include diabetes prevention education, chronic disease management classes, Act Get Up, Get Moving Childhood Obesity Program, Healthy for Life exercise and cooking classes. Memorials Community Health Department puts on a number of community outreach screening and education events yearly in 2018, 10,207 community members participated in these events and programs. Memorials second objective for this priority area is focused on chronic disease screenings and a number of strategies are being deployed to ensure that we meet or exceed the 75th percentile targets of the National Committee for Quality Assurances Healthcare effectiveness data and information set for cancer, diabetes, cardiovascular disease and sexually transmitted infections specifically, chlamydia. Adverse Childhood Experiences We have worked to mitigate adverse childhood experiences ACES by implementing evidence-based practices proven to decrease long-term poor health outcomes. Nurse Family Partnerships NFP is an evidence-based nurse home visitation program that enrolls first-time low-income mothers early in their pregnancy and follows them throughout their childs second birthday. The goal of NFP is to improve child health and development by helping parents provide responsible and competent care for their children. Furthermore, families economic self-sufficiency is improved by helping parents develop a vision for their own future, plan future pregnancies, continue their education and find work. Healthy Pregnancy is an enhanced preventive health and education service intervention for eligible pregnant clients. Services are provided any time in pregnancy based on the mothers individual risks and needs. Infant case care management provides services to improve the welfare of infants by providing their parents with information and assistance for necessary medical, social, educational and other services throughout the infants first year. Infant Mortality The Community Health Needs Assessment showed high and increasing rates of infant mortality in the Native American population in Yakima County. Memorial is a partner in TTAWAXT, a multi-agency collaborative effort led by Indian Health Services on the Yakama Reservation, to investigate and reduce infant mortality and promote healthy families within tribal communities. Memorial participates in the Obstetrics Clinical Outcomes Assessment Program OB COAP, a Foundation for Health Care Quality FHCQ Program which focuses on health professionals decisions made during labor and delivery. As an OB COAP participant we provide specific chart-abstracted data about the care given to women during labor, delivery and postpartum periods which FHCQ then utilizes for analysis and discussion to evaluate labor management practices and interventions commonly used in labor and delivery and compare implications of care decisions. This allows for opportunities to explore methods for actionable and sustainable improvements in hospitals across the state. Data has shown this program has the potential to reduce up to 3,000 neonatal intensive care cases per year. The Virginia Mason Memorial Implementation Plan 2017-2019 can be found on our website www.yakimamemorial.org/about-us-community-benefits.asp.

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?35
Name and address		Type of Facility (describe)
1	North Star Lodge 808 N 39th Avenue Yakima,WA98902	Cancer Treatment Facility
2	Valley Imaging 314 S 11th Avenue Yakima,WA98902	Radiology
3	Orthopedics Northwest 1211 N 16th Avenue Yakima,WA98902	Outpatient Physician Clinic
4	Yakima Heart Center at Memorial Trust 406 S 30th Avenue Suite 101 Yakima,WA98902	Outpatient Physician Clinic
5	Yakima Valley Home Health 302 S 10th Avenue Yakima,WA98902	Home Health and Hospice
6	Yakima Gastroenterology Associates 3909 Creekside Loop Suite 120 Yakima,WA98908	Outpatient Physician Clinic
7	Physicians Anesthesia 406 S 30th Avenue Suite 202 Yakima,WA98902	Outpatient Physician Clinic
8	Pain Center - Water's Edge 1460 N 16th Avenue Suite D Yakima,WA98902	Outpatient Physician Clinic
9	Yakima Urology Associates at Memorial Trust 2500 Racquet Lane Yakima,WA98902	Outpatient Physician Clinic
10	Ridgeview Surgery 2500 Racquet Lane Suite 150 Yakima,WA98902	Outpatient Surgery Center
11	Memorial Sleep Specialists 406 S 30th Avenue Suite 206 Yakima,WA98902	Outpatient Physician Clinic
12	Memorial Cornerstone Medicine 4003 Creekside Loop Yakima,WA98908	Outpatient Physician Clinic
13	Memorial Physicians Lab 4003 Creekside Loop Yakima,WA98908	Medical Laboratory
14	Ohana 1515 W Yakima Avenue Yakima,WA98902	Mammography
15	Generations OBGYN 3003 Tieton Drive Suite 230 Yakima,WA98902	Outpatient Physician Clinic
16	YGA Ambulatory Surgery 3909 Creekside Loop Suite 120 Yakima,WA98908	Outpatient Physician Clinic
17	Yakima Ear Nose and Throat 1601 Creekside Loop Yakima,WA98902	Outpatient Physician Clinic
18	Yakima Vascular Associates 1607 Creekside Loop Suite 100 Yakima,WA98902	Outpatient Physician Clinic
19	Lakeview Spine 1470 N 16th Avenue Yakima,WA98902	Therapy
20	Cascade Surgical Partners 3003 Tieton Drive Suite 300 Yakima,WA98902	Outpatient Physician Clinic
21	Pulmonology 303 Holton Avenue Suite 1 Yakima,WA98902	Outpatient Physician Clinic
22	Family Medicine of Yakima 504 N 40th Avenue Yakima,WA98908	Outpatient Physician Clinic
23	Pacific Crest Family Medicine 311 S 72nd Avenue Yakima,WA98908	Outpatient Physician Clinic
24	Apple Valley Family Medicine 1008 S 38th Avenue Yakima,WA98902	Outpatient Physician Clinic
25	Selah Family Medicine 620 N Park Drive Selah,WA98942	Outpatient Physician Clinic
26	YGA Histology 3909 Creekside Loop Suite 120 Yakima,WA98908	Outpatient Physician Clinic
27	Healthy Now West Valley 120 S 72nd Avenue Suite 102 Yakima,WA98908	Urgent Care
28	Healthy Now - 40th 3909 Creekside Loop Suite 130 Yakima,WA98908	Urgent Care
29	Yakima Podiatry Associates 1607 Creekside Loop Suite 140 Yakima,WA98902	Outpatient Physician Clinic
30	Healthy Now Terrace Heights 3904 Terrrace Heights Drive Yakima,WA98901	Urgent Care
31	Zillah Family Medicine 616 Railroad Avenue Suite 12 Zillah,WA98953	Outpatient Physician Clinic
32	Memorial Outpatient Psych 1460 N 16th Avenue Suite C Yakima,WA98902	Outpatient Physician Clinic
33	Yakima Endocrinology Associates 1470 N 16th Avenue Yakima,WA98902	Outpatient Physician Clinic
34	Garden Village 206 S 10th Avenue Yakima,WA98902	Nursing Home
35	Children's Village 3801 Kern Road Yakima,WA98902	Child Therapy

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I Line 6a	Washington State does not require that non-profit hospitals prepare a community benefit report or make it available to the public. Memorial does prepare and publish a report yearly. The 2017 Community Benefit Report was completed in December of 2018 and made available on the website www.yakimamemorial.org/about-us-community-benefits.asp.
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.
Part II	Economic Development opportunities are provided through Community Building Donations which consist of donations made to community organizations to promote economic development in the Yakima Valley, including donations made to Yakima County Development Association to support new small business ventures in the Yakima Valley and support of the new YMCA facility in Yakima. Youthworks is a youth empowerment and community service initiative engaging youth directly through mentoring, volunteering and philanthropy, while promoting community health improvement advocacy. Non-Health Profession Education facilitates workforce development by providing on the job training for students in non-clinical fields at various departments across the hospital. These include Business Services Billing and Coding, Human Resources, and Information Technology.
Part III Line 2	Memorial used ratio of patient care cost to charges methodology to calculate the amount on line 2. Our financial statements include a footnote regarding uncollectible accounts which are reported as an offset to patient revenue.
Part III Line 4	Memorial used ratio of patient care cost to charges methodology to calculate the amount on line 2. Our financial statements include a footnote regarding uncollectible accounts which are reported as an offset to patient revenue. See pages 13 and 14 of the financial statements.
Part III Line 8	To the extent that costs using the Medicare cost report exceed charges, this shortfall should be regarded as community benefit because we treat and maintain the health of our large local Medicare population despite the necessary subsidization of these health benefits. Memorial used ratio of patient care cost to charges methodology to calculate the amount on line 6. Our financial statements include a footnote regarding uncollectible accounts which are reported as an offset to patient revenue.
Part III Line 9b	During the admittance process at Memorial, all patients are provided with the hospitals financial assistance and charity care information. Eligibility for assistance is determined upon admission to the hospital, and eligible patients are not billed for services.
Part VI Line 2	Memorial conducts a Community Health Needs Assessment every three years, the two most recent reports can be found at www.yakimamemorial.org/about-us-community-benefits.asp. In addition, the hospital routinely looks at health care indicators from county health rankings, US Census, healthy youth survey, Washington State Department of Health and other sources to assist with program planning and development of community benefit programs. Internal data is also analyzed for development and quality improvement of Community Benefit Health Programs. The current Community Health Needs Assessment was adopted by the Memorial Board of Directors on November 29, 2016 and is publicly available.
Part VI Line 3	Memorial informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the Memorials charity care policy at various points beginning with scheduling and continuing through the patient billing process. The following language, or a close variation, is included in our guide to patient services, Understanding Your Hospital Bill brochure, public signage at the main and Emergency Department entrances, as well as on our patient statements Yakima Valley Memorial Hospital provides charity care in accordance with RCW 70.170.060. Applying for medical assistance with DSHS is a prerequisite to a charity care determination of eligibility. Please contact Patient Accounts if you would like to apply for charity or have questions regarding Memorials Charity Care Program. And/or The Hospital is able to provide free or discounted care for all or part of your hospital bills if you qualify, based on your income. Please request a charity care application, fill it out completely, and promptly return it to Business Services. We also contract with Cardon Outreach to screen all self-pay and contract care patients for Medicaid eligibility and assist them with completing all of the prerequisite paperwork, etc. If a patient is not eligible for assistance and cannot pay, Cardon provides the patient with a Charity Care application.
Part VI Line 4	Yakima County is composed of primarily rural communities 14 cities and towns in Central Washington, spanning 4,296 square miles. Total current population for Yakima County as of July 1, 2017 is 251,193. The population density for this area, estimated at 58.2 persons per square mile, is less than the national average population density of 92 persons per square mile. The Primary Service Area PSA of Yakima Valley Memorial Hospital is comprised of Yakima County. Secondary Service Areas SSA for highly specialized programs and services e.g. Childrens Village stretches into neighboring counties including Kittitas and Klickitat. Located within Yakima County is the Yakama Nation Reservation which is over 1 million acres and reaches across the Cascades. Yakima County consists of 50.1 male and 49.9 female population. Nearly half 48.6 of the population is married, while 32.6 report never being married, and the remaining 18.8 consists of residents who are married but separated 23.6, divorced 10.7 or widowed 5.4. Yakima County is home to approximately 10,000 migrant and seasonal farmworkers and their dependents. The percentage of the population living in urban areas is 76.5 compared with 24 living in rural areas, which is a higher proportion of rural population than both National and Washington State averages - 81 vs. 19 and 84 v. 16, respectively. Yakima County consists of a 66.6 Medicare/Medicaid payer mix 16.7 Medicare and 49.9 Medicaid. According to the Washington State Department of Social and Health Services 42.4 of the population is receiving economical services assistance, primarily for child support services, childcare, and basic food programs. Our community is composed of 48.4 of Hispanic or Latino Origin and 44.3 of persons of White Non-Hispanic or Latino Origin, and 3.6 American Indian and Alaska Native. 19 of persons living below poverty level, 7.5 are unemployed and 15.9 have no health insurance.
Part VI Line 5	Memorial is committed to leading, facilitating, partnering and promoting the health of Central Washington. The promotion of community health is accomplished through collaborations, research based education and interventions focused on disparity gaps and social determinants of health. Surplus funding is used to provide oversight, program planning and evaluation as well as direct care to children with special health care needs through Childrens Village, and promotion of well-being through evidence based community health programming. This includes chronic health issues and other risk factors that contribute to poor health outcomes. Memorial has a dedicated staff, contractors and FTE positions to accomplish the development, planning and interventions to address community needs. Memorial budgets surplus funds to allow continuing support of education through partnerships with Pacific Northwest University, Central Washington Family Practice Residency, obstetrical education and ensuring Memorial has the staff to support our communities education needs. Funds are also used to ensure that we have the facilities and equipment to meet the greatest needs of the community examples include Healthy Now Clinics, expanding the inpatient psychiatric department and Cottage in the Meadow for end of life care. To meet the access needs of the community Memorial extends medical staff privileges to all qualified physicians within the community who apply to its medical staff, and allied health staff and who meet qualifications set forth in the Medical Staffs Bylaws, Rules and Regulations, policies and specific departmental privileging documents. For the most critical shortages, particularly within specialty areas Memorial extends the privileges to physicians outside of the community to meet the need.
Part VI Line 5	continued The majority of Memorials governing body consists of persons who reside within the primary service area of the hospital Yakima County no members of the governing body are considered employees or independent contractors, nor do they have family members thereof.

Schedule H (Form 990) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Yakima Valley Memorial Hospital Association

Employer identification number
91-0567263

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Prime Time Inc 6 South 2nd Street Ste 815 Yakima,WA98901	91-1348128	501 C 3	5,000	General Support
(2) Kiwanis Club of Yakima PO Box 611 Yakima,WA98907	52-1068009	501 C 3	12,000	General Support
(3) Yakima County Development New Vision PO Box 1387 Yakima,WA98907	91-1284283	501 C 6	10,000	General Support
(4) Greater Yakima Chamber 10 North 9th Street Yakima,WA98901	91-0480620	501 C 6	15,000	General Support
(5) Yakima Family YMCA 5 North Naches Ave Yakima,WA98901	91-0568717	501 C 3	114,584	General Support
(6) City of Union Gap Sun Camp UG Youth Foundation PO Box 3245 Union Gap,WA98903	91-1727983	501 C 3	5,000	General Support
(7) Wellness House 210 South 11th Ave Ste 40 Yakima,WA98902	91-1418100	501 C 3	10,000	General Support
(8) Union Gospel Mission 1300 N First Street Yakima,WA98901	23-7050061	501 C 3	90,000	General Support
(9) Junior League of Yakima 32 N 3rd Street Suite 430 Yakima,WA98901	23-7175185	501 C 3	12,000	General Support
(10) Yakima Greenway Foundation 111 S 18th St Yakima,WA98901	91-1110737	501 C 3	15,000	General Support
(11) Yakima Chamber Foundation PO Box 1490 Yakima,WA98907	91-1692873	501 C 3	5,000	General Support
(12) Safe Yakima Valley 10 North 9th Street Yakima,WA98901	26-3266828	501 C 3	5,000	General Support
(13) Capitol Theatre PO Box 102 19 S 3rd St Yakima,WA98907	91-0939384	501 C 3	5,000	Scholarship
(14) Yakima Town Hall 5808A Summitview PMB259 Yakima,WA98908	23-7209728	501 C 3	5,000	General Support
(15) Washington Poison Center 155 NE 100th St Suite 100 Seattle,WA98125	94-3214597	501 C 3	20,000	General Support
(16) Yakima Valley Information Center 101 N Fair Avenue Yakima,WA98901	91-0788723	501 C 6	50,000	General Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Part I Line 2

Memorial supports programs or activities that demonstrate a community benefit, are consistent with the objectives of the hospitals Community Health Needs Assessment, support the values of the hospital and improve health in and around Yakima County. Memorial tracks all community benefit/community investment activities. Memorial requires all recipients of community investment dollars to report the impact made by the funding. This is specifically stipulated in a letter that accompanies any Memorial monies which requests that recipients provide information on how the award was used and the specific outcomes they were able to address or impact as a result of the funding. Recipients are asked to supply that information to Memorials Community Health division. The Community Health team follows up regularly on those requests and keeps documented records of receipt.

Schedule I (Form 990) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Russell Myers President/CEO	(i) (ii)	506,147 -------------	-------------	6,050 -------------	47,324 -------------	23,836 -------------	583,357 -------------	-------------
2Tim Reed Vice President/CFO	(i) (ii)	290,166 -------------	-------------	2,652 -------------	37,587 -------------	27,997 -------------	358,402 -------------	-------------
3Scott Lancaster DO MP/CEO, Former key employee	(i) (ii)	321,762 -------------	-------------	2,656 -------------	37,695 -------------	28,050 -------------	390,163 -------------	-------------
4Diane Patterson Vice President, CCO	(i) (ii)	260,517 -------------	-------------	3,494 -------------	33,248 -------------	27,923 -------------	325,182 -------------	-------------
5James Aberle Vice President, Operations, Former Key Employee	(i) (ii)	146,671 -------------	-------------	502,444 -------------	26,394 -------------	13,391 -------------	688,900 -------------	-------------
6Jeff Yamada Vice President, CIO, Former Key Employee	(i) (ii)	14,509 -------------	-------------	562,774 -------------	15,487 -------------	813 -------------	593,583 -------------	-------------
7Matthew Kollman MP/COO	(i) (ii)	188,153 -------------	-------------	1,872 -------------	26,897 -------------	26,624 -------------	243,546 -------------	-------------
8Vu Le Physician - MP	(i) (ii)	406,901 -------------	610,433 -------------	900 -------------	13,750 -------------	25,007 -------------	1,056,991 -------------	-------------
9Rick Gross Physician - MP	(i) (ii)	392,966 -------------	101,526 -------------	35,142 -------------	43,192 -------------	18,020 -------------	590,846 -------------	-------------
10Christopher Tan Physician - MP	(i) (ii)	410,039 -------------	343,565 -------------	965 -------------	34,134 -------------	103 -------------	788,806 -------------	-------------
11Tekchand Tanwani Physician - MP	(i) (ii)	375,876 -------------	174,159 -------------	1,248 -------------	39,620 -------------	28,269 -------------	619,172 -------------	-------------
12Kevin Harrington Physician - MP	(i) (ii)	509,010 -------------	100,466 -------------	1,625 -------------	36,638 -------------	9,930 -------------	657,669 -------------	-------------
13Edward Miles Vice President, Integration and Development, Former Key Employee	(i) (ii)	121,105 -------------	-------------	194,355 -------------	20,504 -------------	15,482 -------------	351,446 -------------	-------------
14Jolene Seda Vice President, People Culture, Former Key Employee	(i) (ii)	198,193 -------------	-------------	2,540 -------------	34,723 -------------	28,051 -------------	263,507 -------------	-------------
15Shawnie Haas ACO/CEO, Former Key Employee	(i) (ii)	187,952 -------------	-------------	2,350 -------------	34,811 -------------	27,997 -------------	253,110 -------------	-------------

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I Line 4a	James Aberle received a severance payment of 500,252. Edward Miles received a severance payment of 192,325. Jeff Yamada received a severance payment of 562,067.
Part I Line 4b	In July 2002, Memorials Board of Directors adopted a salary continuation plan the Plan, in the form of a non-qualified retirement benefit for senior executives. The retirement benefit provided by the plan is supplementary to Memorials employee pension plan, tax-deferred annuity retirement plan, 401k plan and social security retirement earnings. Benefits are calculated as the difference between the projected age 65 value of the aforementioned benefits and 75 of the lump sum at age 65. No benefits under the plan are generally available for a senior executive who retires prior to his/her 65th birthday. Funding for the plan began in 2002, and Memorial first began accruing a liability for the plan during the fiscal year ending October 31, 2005. Memorials liability accrual is based on the assumption that both executives will be working until age 65.
Part I Line 4b	Russell Myers accrued benefits of 3,856 in the Plan. Diane Patterson accrued benefits of 0 in the Plan.
Part I Line 7	Variable compensation amounts are calculated based off of the results of the strategic scorecard as well as the employees individual evaluation. This is then multiplied by the employees gross earnings for the previous year. This is approved by the Virginia Mason Health System Compensation and Benefits Committee, and documented in its minutes.

Schedule J (Form 990) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Yakima Valley Memorial Hospital Association

Employer identification number
91-0567263

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Washington Health Care Facilities Authority	91-1108929	93870HGN0	08-17-2012	38,005,000	See Part VI		X		X		X
B	Washington Health Care Facilities Authority	91-1108929	93978HRJ6	11-10-2016	34,208,306	Building and Equipment		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	22,485,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	38,011,438		34,418,528
4 Gross proceeds in reserve funds .............	2,269,004		2,554,530
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	687,697		678,328
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			29,852,413
11 Other spent proceeds .............	37,323,741
12 Other unspent proceeds .............			1,333,257
13 Year of substantial completion .............	2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X
15 Were the bonds issued as part of an advance refunding issue? .....	X			X
16 Has the final allocation of proceeds been made? ..........	X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X
b Exception to rebate? ........	X			X
c No rebate due? .........	X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Part I Line A , Column F	Refund prior bonds 03/14/1996 and 11/13/2002
Part II Line 3	The total proceeds do not agree to the issue price in Part I, Column E due to investment earnings. The total proceeds do not equal the summation of lines 4 - 12 due to transferred or replacement proceeds in Line 4.
Part IV Line 2c, column A	Issuer Name Washington Health Care Facilities Authority. Date the Rebate Computation was performed 07/31/2017.

Schedule K (Form 990) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Juan Jimenez	Family member of Maribel Jimenez, Director	82,556	Employment		No
(2) Miranda Yamada	Family member of Jeff Yamada, former key employee	39,360	Employment		No
(3) Leslie Yamada	Family member of Jeff Yamada, former key employee	60,606	Employment		No
(4) M G Wagner Co Inc	Entity more than 35 owned by Scott Wagner, Director	846,404	Provison of roofing services to the Hospital		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
Part IV Line 1a	Name of Person Juan Jimenez
Part IV Line 1b	Relationship between interested person and organization Family member of Maribel Jimenez, Director
Part IV Line 1c	Amount of Transaction 82,556
Part IV Line 1c	Description of Transaction Employment
Part IV Line 1e	Sharing of Organization Revenues No
Part IV Line 2a	Name of Person Miranda Yamada
Part IV Line 2b	Relationship between person and organization Family member of Jeff Yamada, former key employee
Part IV Line 2c	Amount of Transaction 39,360
Part IV Line 2d	Description of Transaction Employment
Part IV Line 2e	Sharing of Organization Revenues No
Part IV Line 3a	Name of Person Leslie Yamada
Part IV Line 3b	Relationship between person and organization Family member of Jeff Yamada, former key employee
Part IV Line 3c	Amount of Transaction 60,606
Part IV Line 3d	Description of Transaction Employment
Part IV Line 3e	Sharing of Organization Revenues No
Part IV Line 4a	Name of Organization M. G. Wagner Co Inc
Part IV Line 4b	Relationship Entity more than 35 owned by Scott Wagner, Director, Chairman
Part IV Line 4c	Amount of Transaction 846,404
Part IV Line 4d	Description of Transaction Provision of roofing services to the Hospital
Part IV Line 4e	Sharing of Organization Revenues No

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Return Reference	Explanation
Form 990, Part III, Line 1	The hospital does this by upholding the values of respect, accountability, teamwork, stewardship and innovation. By helping patients achieve health, we also create healthy communities. VMM has a multispecialty team of more than 300 physicians, offering primary and specialty care, convenience care clinics, as well as operating one of the regions busiest emergency departments. Our network of clinics surrounds the Yakima Valley, and extends northwest into Ellensburg and southeast to Sunnyside. Virginia Mason Memorial also operates Cottage in the Meadow, a 24-hour, 20-bed inpatient hospice facility which serves the entire Yakima Valley. We also collaborate to operate Childrens Village, a clinic that serves children with special and developmental healthcare needs and their families, and Garden Village, a skilled nursing facility, providing the highest level of comfort-driven, quality care to those with complex and long-term medical and psychiatric needs. Virginia Mason Memorial funds the Central Washington Family Medicine Residency Program CWFMR, a 30 resident family medicine residency program, in additon to offering training programs for nursing, pharmacy, respiratory therapy, physical therapy and laboratory technology.
Form 990, Part III, Line 2	Virginia Mason Memorial VMM, along with Yakima Valley Farm Workers Clinic Farm Workers an IRC Section 501c3 public charity, and the Memorial Foundation the Foundation also an IRC Section 501c3 public charity, have for several years collaborated to operate Childrens Village, a clinic that serves chidren with special and developmental healthcare needs in Yakima, Washington. On November 7, 2018, VMM, Farm Workers, and the Foundation caused to be filed Articles of Incorporation for a new Washington nonprofit corporation called Childrens Village the CV corporation. VMM, Farm Workers, and the Foundation are the sole voting members of the CV Corporation with equal voting rights and the right collectively to appoint all of the directors of the Corporation. The CV Corporation is organized and will be operated exclusively for charitable purposes within the meaning of IRC Section 501c3, and is intended to qualify as a Type I supporting organization within the meaning of IRC Section 509a3 by conducting activities to carry out the purposes of its three members, and specifically to provide health resource coordination among the members and other entities for the delivery of early intervention health care services to children with special health care needs.
Form 990, Part III, Line 4a	VMMs Oncology programs delivered charity care services 2,085 times in 2018. Childrens Village, based in Yakima, is a clinic that provides healthcare services for children with special needs. The facility also houses the Nurse Family Partnership, a program that provides specially trained nurses to help first-time mothers during pregnancy and until the childs second birthday. These programs provided the charity care and unreimbursed Medical services on eight separate occasions. Maternal Health Services provides community-based programs and services focused on providing preventative health and education for families throughout Central Washington. 12 patient encounters with maternal health services were funded through charity care. VMMs pain management clinic saw 819 patient encounters which fell under VMMs charity care criteria. Memorials Ohana clinic provides breast health education, screening and diagnostic mammography, and breast care coordination for women in the Yakima Valley. Charity care funded 150 encounters with Ohana providers in 2018. There were 644 Medicare/Medicaid patient encounters in outpatient surgery in 2018. Virginia Mason Memorials Wound Management Services combines traditional practices and medicines for wound healing with technology, such as hyperbaric oxygen therapy. These services are offered to patients who have undergone 30 days of conventional wound treatment without significant improvement. In 2018, 206 of those encounters were performed under charity care assistance. In total, Virginia Mason Memorial served 6,942 charity care patients in an outpatient setting in 2018. VMM received 716,386 in Medicaid funding for the outpatient services provided in 2018. Additional outpatient services for Medicare/Medicaid patients include cardiac rehab 22 encounters, education 17 encounters, infusion care 627 encounters, laboratory 100 encounters, physicians offices 254 encounters, outpatient procedures 644 encounters, pre-procedure testing 264 encounters, sleep studies 48 encounters, therapy 84 encounters, x-ray and imaging 569 encounters, and cardiovascular care provided by the Yakima Heart Center 578 encounters.
Form 990, Part III, Line 4b	In 2018, VMMs OB/GYN department provided charity care to patients for pre-delivery testing 32 encounters and obstetric emergency care 58 encounters. The total amount of charity care funds disbursed in 2018 for these encounters was 17,253, a 17 increase from the previous year. VMMs Inpatient Psychiatric Services treats adult patients for a broad spectrum of mental health concerns including depression, anxiety, adjustment disorders, ADD/ADHD, and major psychiatric illness. Inpatient psychiatric services also offers psychiatric evaluation and medication management, in addition to treatment of underlying medical conditions. Charity care was provided psychiatric services in 9 instances during 2018. With one of the busiest emergency departments in the State of Washington, our providers are trained in emergency medicine and treat over 87,000 patients a year regardless of age, culture, employment, ethnicity, expression, gender identity, language, national origin, participation in programs, physical or mental disability, race, color, religion, services and activities, sex, sexual orientation, socioeconomic status, or financial status. The Emergency Department provides for patients emergent needs and, all patients presenting to the Emergency Department are examined by a trained provider. VMMs emergency department experienced 5,229 patient encounters with charity care recipients in 2018, for a total of 3,851,325 in Medicaid/Medicare funds, a 57 increase over the previous year. VMMs inpatient pharmacy services had 275 patient encounters in 2018. These services accounted for 14,753 in charity care funds, a 31 increase in Medicaid/Medicare encounters from 2017 to 2018. Virginia Mason Memorials respiratory therapy department provides specialized care to patients being treated in our critical care/intensive care unit, pediatric, neonatal intensive care units, operating room, post-anesthesia area, diagnostic imaging, emergency department, ambulatory care and medical surgical services unit. Respiratory care had 15 encounters with charity care patients in 2018.
Form 990, Part III, Line 4d	Virginia Mason Memorial provides community health education, support, and services to residents of Yakima County. These programs align with initiatives and disparities outlined within our published Community Health Needs Assessment. Community Health programs served 10,207 residents in 2018 and equated to 322,155 in community investment donations. Virginia Mason Memorial partnered with the local YMCA to deliver Actively Changing Together, a childhood obesity program that assisted 126 families. VMMs chronic disease self-management program served 82 chronically ill members of the Yakima community. Diabetes prevention and diabetes wellness programs were also offered to 857 community members during the year. In addition to campaigns targeting obesity and diabetes, VMM saw 2,300 attendees at their Fiesta de Salud health fair, and in partnership with Kohls department store, VMM created access to free Zumba and yoga classes for 6,842 adults and children as part of an annual Healthy for Life campaign. In additon to supporting community health initiatives, VMM also supports community investment by making several contributions to not-for-profit causes throughout Yakima County. The Yakima Greenway is a community green space comprised of 20 miles of paved pathway, parks, ponds, picnic areas, playgrounds, and river access. Memorial donated 10,000 to program development and trail support at the Greenway. Kiwanis Club of Yakima received a 12,000 donation to initiate a Free Bikes 4 Kidz program, where volunteers collect and restore used bicycles and donate them to children in need. This program also supports bicycle riding, a healthy activity. The Hispanic Chamber of Commerce received 1,000 for Cinco de Mayo scholarships for Latino students. Yakima Union Gospel Mission medical clinic was the recipient of 120,000 for clinic support. The mission serves nearly 14,000 patients free of charge every year, helping to stem overutilization of emergency department resources and helping to provide additional primary care access to the underserved. Childrens Wishes Dreams is a non-profit providing wishes dreams to terminally ill children in the Yakima area. In 2018, VMM donated 5,000 to the organization for a wish requiring medical supplies. Another beneficiary of our commitment to the community is Camp Prime Time. This organization received 5,000 for support of their outdoor camps for kids with disabilities. The Greater Yakima chamber of Commerce received 15,000 for support of Leadership Yakima, a program meant to strengthen and educate community leaders by providing participants with in-dept insights into a variety of issues impacting residents of the Yakima Valley. The Second Harvest Food Bank backpack program at Harrah Elementary received 4,500 for their program supporting kids who receive free or reduced lunches, by providing them with a backpack full of food on Friday to support them through the weekend. 5,000 was donated to Safe Yakima Valley in support of the Strengthening Families program, which focuses on building resiliency skills throughout the community. The Union Gap Youth Foundations Sun Camp benefitted from a 5,000 donation. The camp aims to prevent substance use and violence. Wellness House, an organization supporting the families of those with cancer or other life-altering illnesses in the Yakima area, received 10,000 for program support. 3,572 was given to Washington State University in the form of a nursing scholarship. The Sozo Sports complex received a 1,500 donation from VMM in support of athletic programs for children who lack sufficient funds to participate. The Yakima County Development Association/New Vision received 10,000 for community development initiatives. Lastly, the Yakima Family YMCA is in the process of constructing a new aquatic facility that will help at-risk kids and Virginia Mason Memorial was able to contribute 114,584 toward construction and the development of rehabilitation services.
Form 990, Part VI, Section A, Line 1a	The governing body delegates to an Executive Committee comprised of the Chairman, Vice Chairman, Secretary and Treasurer the authority of the Board of Directors in the management of the corporation to act only in time sensitive or emergency situations as determined by the Executive Committee, such authority to be exercised in time periods between regularly scheduled meetings of the Board of Directors. All members of the Executive Committee are members of the governing body of the corporation. The Executive Committee does not have the authority to amend, alter or repeal the Bylaws, elect, appoint or remove any member of the Executive Committee or any director or officer of the corporation amend the articles of incorporation adopt a plan of merger or adopt a plan of consolidation with another corporation authorize the sale, lease or exchange of all or substantially all of the property and assets of the corporation not in the ordinary course of business authorize the voluntary dissolution of the corporation or revoke proceedings therefore adopt a plan for the distribution of the assets of the corporation amend, alter or repeal any resolution of the Board which by its terms provides that it shall not be amended, altered or repealed by the Executive Committee or terminate the Chief Executive Officer. The Executive Committee also periodically evaluates the effectiveness of Memorials systems for resolving internal conflicts. The Board also delegates to the Executive Committee the authority of the Board to make all appointments and reappointments to the Medical Staff of the hospital.
Form 990, Part VI, Section A, Line 6, 7	Virginia Mason Health System VMHS is the sole corporate member of Memorial. VMHS as the sole member has the following approval rights 1 Election and approval of Directors and Officers of the Board of Directors 2 approval of the appointment of the Chief Executive Officer 3 Removal of Directors and Officers of the Board of Directors 4 approval of all long-range plans proposed by the Board of Directors 5 Approval of the annual capital and operating budgets proposed by the Board of Directors 6 Approval of the borrowing of funds where the amount is in excess of Ten Million Dollars 7 Approval of the sale, lease, exchange, mortgage, pledge or disposal of all or substantially all of the property and assets 8 Approval of all amendments to the Articles of Incorporation or Bylaws and all other rights and powers as specified in the Washington Nonprofit Corporation Act.
Form 990, Part VI, Section B, Line 11b	The VMHS Audit and Compliance Committee ACC, a committee composed of independent community members has been delegated responsibility for oversight of the annual Form 990 preparation process including 1 selection, engagement, and performance of an independent tax preparer 2 review of the annual draft Form 990 and 990-T tax returns, and 3 recommending the final Form 990 and 990-T tax returns for review to the Memorial Board of Directors. Annually, at the September meeting, management and the tax preparer provide the ACC with an initial draft of the Form 990 and present an overview of the Form 990 preparation process. The final draft Form 990 is reviewed and approved by the ACC in November followed by a Board review of the final Form 990 prior to filing. The final Form 990 and 990-T tax returns are provided to each member of the Memorial Board of Directors via electronic delivery.
Form 990, Part VII, Section B, Line 12c	The VMHS Governance Committee has accountability for oversight of the process for disclosure, evaluation and management of conflicts of interest involving any member of the Board, executive leadership or key employees Covered Person. Pursuant to the Conflicts of Interest Policy, an annual conflict of interest questionnaire is distributed to all Covered Persons. In addition, a Covered Person has an on-going duty to disclose the existence of a conflict of interest at any time an actual or potential conflict arises. Each Covered Person is required upon appointment and annually thereafter to attest to a statement that affirms that such person has 1 received a copy of the Conflicts of Interest Policy 2 has read and understands the Policy 3 has agreed to comply with the Policy and 4 understands that Memorial is a charitable organization and that in order to maintain its federal tax exemption must engage primarily in activities that accomplish its tax-exempt purposes. Written disclosures are reviewed by the Governance Committee to determine if an actual or potential conflict of interest exists and if so, how it should be managed. The Covered Person is informed in writing regarding the determination the Conflict of Interest Management Plan. No Covered Person with an actual or potential conflict of interest shall engage in an activity on Memorials behalf related to the disclosed actual or potential Conflict of Interest unless such activity is permitted by the Conflict of Interest Management Plan or until the Covered Person has undertaken all steps set forth in the Management Plan to manage, reduce or eliminate the conflict. All Covered Persons have a duty to disclose the existence of any actual or potential conflict of interest with respect to meeting agenda items. The Conflicts of Interest Policy requires that copies of the Conflict of Interest Questionnaire be completed annually by each Covered Person and any Conflict of Interest Management Plan be maintained. In addition, the minutes of the board and all committees with board-delegated powers shall document the disclosure and resolution of any actual or potential conflict of interest disclosed at such meeting.
Form 990, Part VI, Section B, Line 15	The VMHS Compensation and Benefits Board Committee, a committee composed solely of independent directors none of whom have a conflict of interest, is accountable for setting reasonable total compensation packages for each Memorial executive, including the CEO, officers and key employees Executives consistent with Virginia Masons philosophy and principles. The Board develops and approves annual goals and performance criteria which are used in determining merit increases and variable compensation opportunities for the Memorial Executives. The Committee assesses performance against these goals. The Committee selects and engages a qualified independent compensation consultant to review and analyze the total compensation and benefits packages to the Executives. The Committee as part of its analysis obtains from the compensation consultant appropriate comparability data including total compensation paid by similarly situated for-profit and non-profit health care organizations for positions that are functionally comparable to each of the Executives. With respect to those Executives below the level of Chair/Chief Executive Officer, the Committee requests that the Chair/Chief Executive Officer work with the compensation consultant to formulate a compensation recommendation for each such Executive, consistent with Virginia Masons compensation philosophy and principles. Consistent with Virginia Masons compensation philosophy and principles, the Committee approves total compensation packages for each of the Executives based on information presented to the Committee, reasonableness and the best interests of Memorial. The Committees decisions regarding compensation for each Executive are documented in written resolutions and minutes of the Committee. The Committee promptly reports its action to the Board whose reports are reflected in the Boards minutes. The Executives that were reviewed in 2018 were Chief Executive Officer, Vice Presidents, Chief Clinical Officer, Chief Financial Officer, and Chief Medical Officer.
Form 990, Part VI, Section C, Line 19	The organizations Articles, Bylaws, Conflict of Interest Policy, and Financial Statements are made available upon request.
Form 990, Part IX, Line 11G	Laboratory Program Services Expense 1,584,265 Management and General Expenses 0 Fundraising Expenses 0 Total Expenses 1,584,265. Physician Services Program Services Expense 0 Management and General Expenses 3,265,728 Fundraising Expenses 0 Total Expenses 3,265,728. Contractual Expenses Program Services Expense 43,420,663 Management and General Expenses 521,456 Fundraising Expenses 0 Total Expenses 43,942,119. Other Purchased Services Program Services Expenses 14,547,799 Management and General Expenses 9,842,022 Fundraising Expenses 0 Total Expenses 24,389,821 Total Other Fees 73,181,933.
Form 990, Part XI, Line 9	Additional Pension Adjustment 4,376,512, Donated capital transfers from restricted funds 449,143

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Yakima Valley Memorial Hospital Association

Employer identification number

91-0567263

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) Memorial Physicians 3800 Summitview Yakima,WA98902 26-4379419	Medical Services	WA	39,902,233	3,040,435	YVMHA
(2) Central Washington Healthcare Partners LLC 3800 Summitview Yakima,WA98902 45-3483343	Accountable Care Organization	WA	997,846	331,049	YVMHA
(3) Yakima Heart Center at Memorial Trust 2811 tieton Drive Yakima,WA98902 45-7017902	Medical Services	WA	34,734,663	49,250	YVMHA
(4) Yakima Urology at Memorial Trust 2811 Tieton Drive Yakima,WA98902 47-6620487	Medical Services	WA	15,508,782	10,094	YVMHA
(5) Orthopedics Northwest 1211 N 16th Avenue Yakima,WA98902 82-6150143	Medical Services	WA	42,791,082	124,036	YVMHA

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Garden Village 206 S 10th Avenue Yakima,WA98902 91-2090034	Skilled Nursing	WA	501c3	10	N/A		No
(2)Virginia Mason Health System 1100 Ninth Avenue Seattle,WA98101 91-1351110	Fundraising	WA	501c3	7	N/A	Yes
(3)Virginia Mason Medical Center 1100 Ninth Avenue Seattle,WA98101 91-0565539	Health Care	WA	501c3	3	VMHS		No
(4)Virginia Mason Institute 1100 Ninth Avenue Seattle,WA98101 26-3763656	Education	WA	501c3	9	VMMC		No
(5)Benaroya Research Institute at Virginia Mason 1201 Ninth Avenue Seattle,WA98101 91-0653422	Research	WA	501c3	4	VMHS		No
(6)Children's Village 3801 Kern Road Yakima,WA98902 35-2654720	Supporting Organization	WA	501c3	12	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:	18007340
Software Version:	19.1.1.0

1	Briefly describe the organization’s mission or most significant activities: Virginia Mason Memorial VMM, part of the Virginia Mason Health System, is a 226-bed acute-care, not-for-profit community hospital that has served Central Washingtons Yakima Valley for nearly 70 years.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	3,284
6	Total number of volunteers (estimate if necessary) .............	6	398
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	41,112,793
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,115,360	4,201,219
9	Program service revenue (Part VIII, line 2g) .........	451,760,130	461,698,745
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,918,238	-2,544,936
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	948,914	3,944,696
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	463,742,642	467,299,724
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	185,500	378,584
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	248,445,191	245,952,191
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	217,594,991	232,322,790
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	466,225,682	478,653,565
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,483,040	-11,353,841
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	371,888,685	351,870,446
21	Total liabilities (Part X, line 26).............	149,217,738	144,480,709
22	Net assets or fund balances. Subtract line 21 from line 20.....	222,670,947	207,389,737

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 204,289,731 including grants of $ 34,315 ) (Revenue $ 280,853,843 )
	Outpatient Services. During 2018, Virginia Mason Memorial VMM performed 366,588 outpatient visits for surgery, cancer care, diagnostic testing and various other therapeutic services. Those outpatient services were offered in a manner consistent with the hospitals 501c3 status, including charity care to qualifying patients per the hospitals charity care policy. In 2018, VMM provided charity care and unreimbursed Medicaid services during 6,487 outpatient visits, totaling 2,750,371.76. Continued on Schedule O.

4b	(Code: ) (Expenses $ 90,827,551 including grants of $ 293,311 ) (Revenue $ 135,294,212 )
	Inpatient Services. Virginia Mason Memorial VMM hospital admitted 7,245 patients that qualified for charity care, for a total of 46,942 patient days. These inpatient charity care encounters amounted to 6,312,136.69. Charity care was provided per the terms of the hospitals charity care policy. Inpatient services includes obstetrics gynecology OBGYN, pediatrics, psychiatric services, emergency department ED, hospital imaging, hospital-based physician services, critical care, orthopedics, cardiovascular care, cancer care, anesthesiology, respiratory therapy, and pharmacy. Continued on Schedule O.

4c	(Code: ) (Expenses $ 29,506,191 including grants of $ 50,958 ) (Revenue $ 972,347 )
	Supporting Service. Virginia Mason Memorial provides additional supportive services to serve the health care needs of the community that do not directly align as either inpatient or outpatient services. These supportive services were offered in a manner consistent with the hospitals 501c3 status. These supportive services include educational services for student physicians, nurses, and allied health professionals, support of the Community Health of Central Washington CHCW medical residency program 30 residents, a pre-surgery clinic, nursing float pool, business development, and Information Technology and systems. Continued on Schedule O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 17,410,961 including grants of $ ) (Revenue $ 3,465,931 )
4e	Total program service expenses342,034,434

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Christopher Tan........................................................................ Physician - MP	40.00 .......................	X		754,569	0	34,237
(19) Tekchand Tanwani........................................................................ Physician - MP	40.00 .......................	X		551,283	0	67,889
(20) Kevin Harrington........................................................................ Physician - MP	40.00 .......................	X		611,101	0	46,568
(21) Scott Lancaster DO........................................................................ MP/CEO, Former key employee	40.00 .......................		X	324,418	0	65,745
(22) James Aberle........................................................................ Vice President, Operations, Former Key Employee	40.00 .......................		X	649,115	0	39,785
(23) Jeff Yamada........................................................................ Vice President, CIO, Former Key Employee	40.00 .......................		X	577,283	0	16,300
(24) Edward Miles........................................................................ Vice President, Integration and Development, Former Key Employee	40.00 .......................		X	315,460	0	35,986
(25) Jolene Seda........................................................................ Vice President, People Culture, Former Key Employee	40.00 .......................		X	200,733	0	62,774
(26) Shawnie Haas........................................................................ ACO/CEO, Former Key Employee	40.00 .......................		X	190,302	0	62,808

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,981,183	783,497

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	2,460,502

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,740,717

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		4,201,219

		Business Code
2a	Net patient revenue	621400	419,911,658	419,911,658
b	Memorial Physicians/Signal Health	621110	40,900,078		40,900,078
c	Lab Service	621500	212,334		212,334
d	Expense Reimbursement	900099	632,561	632,561
e
f	All other program service revenue.		42,114	42,114
g	Total. Add lines 2a–2f ....		461,698,745

3 Investment income (including dividends, interest, and othersimilar amounts) ......			-2,544,936			-2,544,936
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		755,213
b	Less: rental expenses		807,620
c	Rental income or (loss)		-52,407
d	Net rental income or (loss)......			-52,407		381	-52,788
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Gift Shop		453220	337,270			337,270
b	Cafeteria		900099	1,992,319			1,992,319
c	Child Care		624410	821,573			821,573
d	All other revenue ....			845,941			845,941
e	Total. Add lines 11a–11d ......			3,997,103
12	Total revenue. See Instructions......			467,299,724	420,586,333	41,112,793	1,399,379

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	378,584	378,584
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	3,666,212	2,606,933	1,059,279
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	201,388,461	132,693,524	68,694,937
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,693,511	6,963,659	2,729,852
9	Other employee benefits .......	16,127,157	11,287,022	4,840,135
10	Payroll taxes ...........	15,076,850	11,275,503	3,801,347
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	632,507	24,135	608,372
c	Accounting ...........	264,524		264,524
d	Lobbying ...........	106,629		106,629
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	73,181,933	59,552,727	13,629,206
12	Advertising and promotion ....	730,463	4,641	725,822
13	Office expenses .......	18,021,951	7,775,364	10,246,587
14	Information technology ......	13,569,984	4,493,335	9,076,649
15	Royalties ..	0
16	Occupancy ...........	9,071,080	2,758,251	6,312,829
17	Travel ............	906,970	438,109	468,861
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	1,861,362		1,861,362
21	Payments to affiliates .......	1,857,714		1,857,714
22	Depreciation, depletion, and amortization ..	20,335,680	19,341,051	994,629
23	Insurance ...	2,966,323	1,065,363	1,900,960
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical supplies	39,006,828	37,093,701	1,913,127
b	Drugs	34,026,507	34,004,981	21,526
c	Dietary Supplies	2,084,153	346,035	1,738,118
d	Sale of assets	18,394		18,394
e	All other expenses	13,679,788	9,931,516	3,748,272
25	Total functional expenses. Add lines 1 through 24e	478,653,565	342,034,434	136,619,131	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			67,838,496	1	65,087,245
2	Savings and temporary cash investments .........			524,890	2	2,788,399
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			56,666,426	4	51,227,983
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....			738,689	7	841,711
8	Inventories for sale or use ........			8,260,156	8	7,739,577
9	Prepaid expenses and deferred charges ......			6,586,079	9	4,217,321
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	265,572,399
b	Less: accumulated depreciation	10b	59,011,065	212,468,290	10c	206,561,334
11	Investments—publicly traded securities .			10,905,360	11	6,199,952
12	Investments—other securities. See Part IV, line 11 .....			3,626,724	12	3,416,385
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			2,152,779	14	1,771,608
15	Other assets. See Part IV, line 11 ...........			2,120,796	15	2,018,931
16	Total assets. Add lines 1 through 15 (must equal line 34)...			371,888,685	16	351,870,446

17	Accounts payable and accrued expenses .....	77,794,348	17	82,913,418
18	Grants payable ...		18
19	Deferred revenue .........	117,049	19	16,591
20	Tax-exempt bond liabilities .........	68,646,745	20	49,556,350
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	2,659,596	23	11,994,350
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	149,217,738	26	144,480,709

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	221,371,349	27	204,856,814
28	Temporarily restricted net assets ...........	1,299,598	28	2,532,923
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	222,670,947	33	207,389,737
34	Total liabilities and net assets/fund balances ........	371,888,685	34	351,870,446