Skyline Hospital officials told attendees at a public forum in White Salmon on Monday night that they have engaged in discussions with four non-profit hospital groups about a potential affiliation.  Skyline CEO Robb Kimmes says they have reached out to PeaceHealth, Providence, Oregon Health Sciences University, and Virginia Mason hospital systems after the Skyline board decided last summer to explore an affiliation or partnership, and are waiting to receive proposals from them.  Kimmes told those in attendance the rapid changes in the health care industry make it challenging for rural hospitals to remain independent.  Kimmes said the board put together a lengthy priority list for any affiliation agreement that includes long-term sustainability, growing and adding services and market share, and finding a good cultural fit that would benefit the community.  Board chair Les Dewey said they wouldn’t agree to shrinking.  Formal proposals are expected to be received this spring, and then the hospital board would pick one to enter into a non-binding agreement to negotiate, and Kimmes emphasized nothing would be final until a formal deal was reached.