Confluence Health System

“Confluence health and affiliates share the same board as part of the operating structure. As such, all board members serve with each other in a similar capacity on related organizations. Additionally, some board members are minority owners in an entity that has a professional service agreement with the organization.”

“The fiduciary standard was updated to include that the organization acts as part of the health system and for the common purposes of the health system as a whole. The conflict of interest section was updated to include that disclosure shall reflect information as to the health system as a whole. The amendment process was updated to include that any proposed amendments to the bylaws will now be reviewed by legal counsel prior to adoption to ensure changes are consistent with applicable laws and standards. The composition of the governing body was updated to reflect the following changes: - chief medical officer for ch shall also serve as the cmo for cwh and wvh. - chief operating officer was replaced with the title hospital administrator. - hospital administrators for each entity will serve as the "chief executive officer" of their respective hospitals. - chief nursing officer was updated to have oversight of the health system as a whole. - chief administrative officer was removed from the governing body.”

“A copy of the form 990 and schedule b, if any, is reviewed by the chief financial officer and vice president of finance. Subsequent to this review the form 990 and schedule b is reviewed by the governing board before being filed with the irs.”

“Board members, executive team members and directors are required to review the current conflict of interest policy and complete an annual questionnaire. The nominating committee of the board reviews questionnaires of existing and new members for potential conflicts of interest. Any potential conflicts of interest are resolved by the nominating committee. The executive team reviews questionnaires submitted by executive team members and directors for potential conflicts of interest. Potential conflicts of interest are resolved by the executive team in collaboration with the corporate compliance officer. Review of all conflict of interest statements is noted within the board minutes.”

“The compensation committee of the governing board annually reviews independent salary survey information and recommends a salary and/or a salary increase for the ceo to the governing board. The other officers receive an annual percent increase which non-contractual employees receive unless the ceo awards a different percentage. The amount is, typically, based on current cpi, market and salary survey information.”

“Confluence health's governing documents, conflict of interest policy, and financial statements are available on request.”

“The covid-19 pandemic has had a significant impact on results for the year ended december 31, 2020. The organization received the first positive test result on march 1, 2020. Effective march 17, 2020 the organization began postponing all elective surgeries and procedures based on guidance from the centers for disease control and prevention (cdc) and the state of washington due to the emergence of covid-19 within washington state. The state of washington also put in place social distancing guidelines and a statewide stay-at-home order on march 23, 2020; however, the organization implemented a work-from-home strategy for our staff during march 2020. Elective surgeries and procedures resumed on approximately may 18, 2020. As the covid-19 pandemic continues, the organization has implemented cost containment strategies and continues to explore opportunities for cost containment. The organization applied for, and received, in available government assistance through various components of the coronavirus aid, relief and economic security (cares) act and has submitted a preliminary request through the federal emergency management agency (fema). Cost containment strategies included participating in the state of washington's shared work program, strict management of consulting and other forms of discretionary spending, restrictions on travel, restricting capital spending for only critical projects, flexing staffing levels to volumes (in addition to the shared work program) and encouraging employees to use paid time off. The organization has received, as of december 31, 2020, $35,639,288 in cares act funds and an additional $72,223,930 in medicare advance payments. No reserve has been placed on the cares act funds while the medicare advance payments are recorded as deferred revenue. Final determination of necessary reserves were made prior to the fiscal year end yet management believes all monies received will ultimately be supported and earned; given the evolving nature of cares act requirements. The organization continues to monitor and assess other covid-19 support funding opportunities as they become available. With volumes rising closer to normal levels towards year end, financial projections for the latter half of 2020 stabilized and showed better than break even performance. While the volatility that subsequent surges of covid-19, or the flu season, cannot be known, if the pandemic levels remain stable or improve the organization expects to generate an operating margin between 2.50% and 3.00% for 2020 based on current financial modeling, which includes funding received from the cares act funds. The range of performance will be affected by the number and magnitude of patient surges, limitation on bed capacity, access to testing supplies, ppe replenishment challenges and erosion in net patient service revenue due to shifts in payor mix caused by the pandemic. Amidst the ongoing covid-19 pandemic management is focused on ensuring its facilities and team remain prepared to meet the communities needs. The organization continues to use its disaster plan to manage all covid-19 matters as well as plan for a surge related to the flu season. The hospital incident command system (hics) triages matters pertaining to its patients, workforce, and health care operations and ensures that federal and state information and guidelines are disseminated throughout the system. The hics team coordinates closely with the local health districts in responding to additional needs identified by the health districts in the communities served. The hics team is also responsible for ensuring the coordination of covid-19 policies, procedures, clinical practices, staffing, logistics and communications across the system enabling the organization to actively manage current patient volumes and to remain prepared for surge needs should they occur. The organization cannot predict whether these measures will be sufficient over the long-term to mitigate the negative effec”

“Cumulative effect of accounting change -429,890.”

“Confluence health is in the process of completing the required a-133 audit for the year ended december 31, 2020. The extended due date for completion is march 31, 2022.”