2024-05-03T17:00:15-05:00 2023-06-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2022-07-01 930425580 GOOD SHEPHERD HEALTH CARE SYSTEM GOOD 5416673400 610 NW 11TH STREET HERMISTON OR 97838 ART MATHISEN CEO 5416673400 2024-04-30 1 ART MATHISEN 999009999 0 SOLOMON MARDAKHAEV P01806552 6105653930 2024-04-30 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z ART MATHISEN 610 NW 11TH STREET HERMISTON OR 97838 193115778 0 X WWW.GSHEALTH.ORG X 1953 OR TO PROVIDE COMPASSIONATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE AND TO PROMOTE A HEALTHY COMMUNITY. 12 12 908 64 0 0 2916644 270888 153110842 177536060 6746458 8173140 1492963 2198519 164266907 188178607 323268 265271 0 0 75382950 83844319 0 0 208806 70464872 84588273 146171090 168697863 18095817 19480744 258405641 301564716 18331427 32397048 240074214 269167668 X TO PROVIDE COMPASSIONATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE AND TO PROMOTE A HEALTHY COMMUNITY. 0 0 149517425 265271 177536060 GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) SERVED 1,724 INPATIENTS OVER 6,070 PATIENT DAYS, 76,397 OUTPATIENTS, AND 24,435 PATIENTS IN OUR EMERGENCY CENTER DURING FISCAL YEAR 2022-2023. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF GSHCS, NOT ALL INDIVIDUALS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. GSHCS PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT DEEPLY DISCOUNTED RATES AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $5,067,299 WRITTEN OFF AS BAD DEBT, AND AN ADDITIONAL $9,229,880 OF DIRECT CHARITY CARE TO OUR COMMUNITY. RECOGNIZING OUR MISSION TO THE COMMUNITY, SERVICES WERE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS DURING THE YEAR WAS $90,658,463. THE UNREIMBURSED AMOUNTS ARE VALUED AT CHARGES FOREGONE. OUR EMERGENCY CENTER IS OPEN AROUND-THE-CLOCK TO ALL COMMUNITY MEMBERS, VISITORS, AND TRAVELERS, WITHOUT REGARD TO ONE'S ABILITY TO PAY. 149517425 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 170 0 908 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X JONATHAN EDWARDS 5416673400 610 NW 11TH STREET HERMISTON OR 97838 ANN RUST SURGEON 40.00 X 1029748 0 0 DAVID MACCABEE SURGEON 40.00 X 842447 0 0 JAMES WHITTUM ORTHOPEDIC SURGEON 40.00 X 830357 0 58671 JEREMY ANDERSON ORTHOPEDIC SURGEON 40.00 X 812429 0 59177 CHRISTOPHER SCOTT CHIROPRACTIC PRACTITIONER 40.00 X 753984 0 42317 BRIAN SIMS CEO (THRU JAN 2023) 40.00 X 437859 0 61409 JAN PETER CHIEF FINANCIAL OFFICER 40.00 X 310983 0 55041 EMMETT SCHUSTER INTERIM CEO (FROM FEB 2023) 40.00 X 297640 0 0 JIM SCHLENKER CHIEF OPERATING OFFICER 40.00 X 290643 0 39037 SUE DAGGETT CHAIRMAN 2.00 X X 0 0 0 TOM WAMSLEY SECRETARY 2.00 1.00 X X 0 0 0 JON LORENCE VICE CHAIR 2.00 1.00 X X 0 0 0 BILL ELFERING TREASURER 2.00 1.00 X X 0 0 0 RACHEL ARCHER DIRECTOR 2.00 X 0 0 0 BOB CARLSON DIRECTOR 2.00 X 0 0 0 DR DEREK EARL DIRECTOR 2.00 X 0 0 0 STEVE ELDRIGE DIRECTOR 2.00 X 0 0 0 ARNELL EYNON DIRECTOR 2.00 X 0 0 0 NANCY MABRY DIRECTOR 2.00 X 0 0 0 LISA MITTELSDORF DIRECTOR 2.00 2.00 X 0 0 0 JEFF WENHOLZ DIRECTOR 2.00 X 0 0 0 5606090 0 315652 193 0 1 0 EMCARE PHYSICIAN SERVICES INC 7032 COLLECTION CENTER DR CHICAGO IL 60693 HOSPITALIST & ER PROVIDER SERVICES 7225986 MAXIM HEALTHCARE SERVICE 12558 COLLECTION CENTER DR CHICAGO IL 60692 TEMP STAFFING 6606797 BOUTEN CONSTRUCTION CO 627 N NAPA ST SPOKANE WA 99202 CONSTRUCTION 6148019 WORKDAY PO BOX 886106 LOS ANGELES CA 90088 ERP SOFTWARE IMPLEMENATION 2512128 TUALATIN IMAGING 7427 SW COHO CT STE 200 TUALATIN OR 97062 DIAGNOSTIC IMAGING READING 1863960 47 68085 70041 132762 270888 PATIENT SERVICE REVENUE 624100 177536060 177536060 177536060 8010306 8010306 5022072 77933 4762038 175133 260034 -97200 162834 162834 CAFETERIA 722514 1218814 1218814 DAYCARE 900099 330365 330365 649340 649340 2198519 188178607 177536060 0 10371659 X 255958 255958 9313 9313 1213069 1213069 65479624 57136987 8202266 140371 2709648 2415265 288449 5934 10784774 9324162 1437705 22907 3657204 3141342 508145 7717 80108 80108 110103 110103 470090 470090 39725182 37001102 2707540 16540 1073287 495915 575480 1892 92690 42828 49699 163 6183444 5649242 534202 2064644 1838886 224959 799 149142 68911 79968 263 522656 241495 280240 921 8042395 7022754 1015712 3929 779124 480512 298612 MEDICAL SUPPLIES 23394377 23061900 327313 5164 MINOR EQUIPMENT 1247675 1229944 17456 275 DUES AND SUBSCRIPTIONS 172384 79650 92430 304 480972 21259 458086 1627 168697863 149517425 18971632 208806 5276894 7011330 22963257 32774707 3960908 4227192 2686285 4732726 148583807 78669534 65555684 69914273 147476381 162665924 2060000 1820257 6569312 7419743 1856920 10998564 258405641 301564716 16175044 13011120 1322500 14125536 833883 5260392 18331427 32397048 X 239442884 268455896 631330 711772 240074214 269167668 258405641 301564716 19480744 9612710 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11949 11949 0 PART II-B, LINE 1: THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 7457266 7457266 93433759 47317307 46116452 41483869 31352227 10131642 6208913 6208913 69914273 ACCRUED LIABILITIES 4333661 LEASE OBLIGATIONS - FINANCING 926731 5260392 X PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 0 1 1 4268935 4268935 0.02530 35145358 30233403 4911955 0.02910 39414293 30233403 9180890 0.05440 34170 2268098 117429 2150669 0.01270 86 1005167 12731 992436 0.00590 63038801 30562636 32476165 0.19250 216608 216608 0.00130 34256 66528674 30692796 35835878 0.21240 34256 105942967 60926199 45016768 0.26680 383598 96424 287174 0.00170 602974 8562 594412 0.00350 986572 104986 881586 0.00520 1 1938951 44622187 46055431 -1433244 X 1 1 1 1 GOOD SHEPHERD HEALTH CARE SYSTEM 610 NW 11TH STREET HERMISTON OR 97838 WWW.GSHEALTH.ORG 055598-6 X X X X GOOD SHEPHERD HEALTH CARE SYSTEM 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X HTTPS://WWW.GSHEALTH.ORG/COMMUNITYBENEFIT X X 1 21 1 HTTPS://WWW.GSHEALTH.ORG/COMMUNITYBENEFIT 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X HTTPS://WWW.GSHEALTH.ORG/PAYING-FOR-YOUR-CARE X HTTPS://WWW.GSHEALTH.ORG/PAYING-FOR-YOUR-CARE X HTTP://GSHCS.NET/PUB/GSHCSCHARITYCAREPOLICY.PDF X X X X X X X 1 X 0 X X X X 1 X 0 0 GOOD SHEPHERD HEALTH CARE SYSTEM PART V, SECTION B, LINE 5: THE CHNA WAS COMPLETED IN DECEMBER 2021 AND WAS CONDUCTED IN PARTNERSHIP WITH ST. ANTHONY HOSPITAL IN PENDLETON, OR. THIS ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWS FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. 829 TOTAL SURVEYS WERE COMPLETED THROUGH 2 MECHANISMS: RANDOM-SAMPLE SURVEYS AND COMMUNITY OUTREACH SURVEYS. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY GOOD SHEPHERD HEALTH CARE SYSTEM AND CHI ST. ANTHONY HOSPITAL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. GOOD SHEPHERD HEALTH CARE SYSTEM PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH ST. ANTHONY HOSPITAL LOCATED IN PENDLETON, OR. GOOD SHEPHERD HEALTH CARE SYSTEM PART V, SECTION B, LINE 7D: THE CHNA WAS MADE WIDELY AVAILABLE THROUGH BOTH GOOD SHEPHERD HEALTH CARE SYSTEM'S WEBSITE AND ST. ANTHONY HOSPITAL'S WEBSITE. PAPER COPIES ARE ALSO AVAILABLE THROUGHOUT GOOD SHEPHERD'S FACILITY, UPON REQUEST. HTTPS://WWW.GSHEALTH.ORG/WP-CONTENT/UPLOADS/UMATILLA_COUNTY_CHNA_2021_REVISED.PDF GOOD SHEPHERD HEALTH CARE SYSTEM PART V, SECTION B, LINE 11: THE MOST RECENT CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS ALONG WITH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THESE NEEDS INCLUDE:ACCESS TO SERVICES/SOCIAL DETERMINANTS OF HEALTH/HEALTH EQUITY:WE WILL CONTINUE OFFERING URGENT CARE SERVICES, CONNEXIONS PROGRAM (CASE MANAGEMENT AND RESOURCE REFERRAL), MEMBERSHIP IN THE LOCAL COMMUNITY HEALTH PARTNERSHIP COUNCIL FOR EOCCO (LCHP) AND SUPPORT OF LCHP OBJECTIVES. WE HAVE MET ALL PROCESS OBJECTIVES FOR THIS PRIORITY AREA: EXPAND URGENT CARE HOURS, INCREASE NUMBER OF PROVIDERS, ED VS. URGENT CARE EDUCATION, AS WELL AS DISTRIBUTE APPROPRIATE EDUCATION VIA MULTIPLE MODES OF MEDIA. WE CONTINUE TO IMPLEMENT NEW STRATEGIES INCLUDING COMMUNITY EDUCATION ON APPROPRIATE USE OF THE EMERGENCY DEPARTMENT, URGENT CARE, AND PRIMARY CARE PROVIDERS (PCPS), INCREASE EFFORTS TO RECRUIT HEALTHCARE PROVIDERS TO MEET THE GROWING POPULATION AND MAKE URGENT CARE SERVICES MORE ACCESSIBLE.OBESITY/CHRONIC DISEASE:WE HAVE MET ALL PROCESS OBJECTIVES FOR THIS PRIORITY AREA EXCEPT FOR 1; #5, THIS PROGRAM WAS NOT RUNNING DUE TO COVID. WE WILL CONTINUE OFFERING BMI MEASUREMENTS AT COMMUNITY SCREENING EVENTS, ENCOURAGING COMMUNITY PARTNERS TO PROMOTE HEALTHY GARDENING AND FOOD CHOICES, CONTINUE TO PROMOTE COMMUNITY-BASED EXERCISE AND FITNESS EDUCATION OPPORTUNITIES. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING NORTHEAST OREGON PRESCRIPTION TRAILS PROGRAM, SUGAR SWEETENED BEVERAGE EDUCATION AT 75% OF COMMUNITY OUTREACH EVENTS, FEASIBILITY ANALYSIS OF METABOLIC AND BARIATRIC PROGRAM, AND CREATION OF COMMUNITY CANCER PREVENTION STRATEGIC PLAN.VIOLENCE:WE HAVE MET ALL PROCESS OBJECTIVES FOR THIS PRIORITY AREA, EXCEPT FOR ONE. DUE TO UNFORESEEN PROJECTS WITHIN OUR EMR, #2 IS STILL IN PROGRESS (FULLY INTEGRATING INTO EPIC). WE WILL CONTINUE OFFERING SAFE COMMUNITIES PARTICIPATION AND START BY BELIEVING CAMPAIGNS. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING COLLABORATE WITH DOMESTIC VIOLENCE SERVICES TO HOST ONE IN HER SHOES EVENT ON SITE ANNUALLY, INTEGRATE ABUSE SCREENING QUESTIONNAIRE INTO EPIC, EXPANSION OF AWARENESS AND SCOPE OF START BY BELIEVING CAMPAIGN LED BY THE SANE TEAM.BEHAVIORAL HEALTH:WE HAVE MET ALL PROCESS OBJECTIVES FOR THIS PRIORITY AREA. WE WILL CONTINUE OFFERING SAFE COMMUNITIES, MEMBERSHIP IN THE LOCAL COMMUNITY HEALTH PARTNERSHIP (LCHP), SUPPORT OF LCHP OBJECTIVES, TOBACCO TREATMENT SPECIALIST (TTS) COUNSELING, AND COMMUNITY TOBACCO EDUCATION AND EVENTS. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING ENSURING UNIFORM COMPLIANCE WITH GSHCS POLICIES REGARDING PRESCRIPTION DRUG MONITORING PROGRAM (PDMP) DASHBOARD USAGE BEFORE PRESCRIBING OPIOIDS OR OTHER ADDICTIVE PRESCRIPTIONS, ENSURING UNIFORM COMPLIANCE WITH GSHCS POLICIES REGARDING REQUIRING DOCTOR/PATIENT AGREEMENT WHEN ON LONG-TERM OPIOID PRESCRIPTIONS, OBTAINING ONE GSHCS EMPLOYED MEDICATION ASSISTED TREATMENT (MAT) PROVIDER, TRAINING SELECT GSHCS STAFF IN NALOXONE ADMINISTRATION, CREATING ONSITE SAFE MEDICATION DISPOSAL SITE, AND DISTRIBUTING ACCURATE INFORMATION ON DRUGS AT VARIOUS COMMUNITY EVENTS.THE HOSPITAL DOES NOT HAVE ADEQUATE RESOURCES TO SOLVE ALL THE PROBLEMS IDENTIFIED. SOME ISSUES ARE BEYOND THE MISSION OF THE HOSPITAL AND ACTION IS BEST SUITED FOR A RESPONSE BY OTHERS OR WILL REQUIRE PERSONAL ACTIONS BY INDIVIDUALS RATHER THAN THE RESPONSE OF AN ORGANIZATION. WE VIEW THE ABOVE STRATEGIES FOR HOW WE, ALONG WITH OTHER ORGANIZATIONS AND AGENCIES, CAN COLLABORATE TO BRING THE BEST EACH HAS TO OFFER TO ADDRESS THE MORE PRESSING IDENTIFIED NEEDS. GOOD SHEPHERD HEALTH CARE SYSTEM PART V, SECTION B, LINE 16J: A SUMMARY OF THE FAP IS DISTRIBUTED IN UNEMPLOYMENT OFFICES AND OTHER AREAS IN THE COMMUNITY THAT TARGET THE ELIGIBLE POPULATION. A SUMMARY IS ALSO AVAILABLE AT LOCAL PHYSICIAN OFFICES, ADMISSIONS OFFICES, AND SENT WITH BILLING INVOICES. ALSO, UPON DISCHARGE, A PATIENT FINANCIAL REPRESENTATIVE MEETS WITH PATIENTS TO DISCUSS THEIR ABILITY TO PAY FOR SERVICES. INCLUDED AS PART OF THIS DISCUSSION IS A SUMMARY OF THE FAP. GOOD SHEPHERD HEALTH CARE SYSTEM PART V, SECTION B, LINE 20E: SCHEDULE H, PART V, SECTION B, LINE 20A: THE ORGANIZATION DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS (ECA'S) 3 1 - GOOD SHEPHERD MEDICAL GROUP 610 NW 11TH STREET HERMISTON OR 97838 CLINIC 2 - VANGE JOHN MEMORIAL HOSPICE 610 NW 11TH STREET HERMISTON OR 97838 HOSPICE 3 - GOOD SHEPHERD HOME HEALTH 610 NW 11TH STREET HERMISTON OR 97838 HOME HEALTH PART I, LN 7 COL(F): BAD DEBT EXPENSE IS INCLUDED IN NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES UNDER THE ACCOUNTING FOR CONTRACTUAL ARRANGEMENTS SECTION AND IN NOTE 5: PATIENT ACCOUNTS RECEIVABLE. PART II, COMMUNITY BUILDING ACTIVITIES: N/A PART III, LINE 2: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2 INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. PART III, LINE 3: MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO CHARITY PATIENTS IS BASED ON AN OVERALL CHARITY CARE PERCENTAGE OF GROSS REVENUE. PART III, LINE 4: BAD DEBT EXPENSE EXPLANATIONS ARE INCLUDED IN NOTE 1: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES UNDER THE ACCOUTING FOR CONTRACTUAL ARRANGEMENTS SECTION AND IN NOTE 5: PATIENT ACCOUNTS RECEIVABLE. PART III, LINE 8: ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES & REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. GSHCS PROVIDES SERVICES TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THEY WILL NOT RECOVER ALL THE COSTS ASSOCIATED WITH PROVIDING THESE SERVICES. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. PART III, LINE 9B: THE ORGANIZATIONS COLLECTION PROCEDURES REQUIRE A FINANCIAL ADVISOR TO WORK WITH ANY PATIENT WHO IS IDENTIFIED AS POTENTIALLY BEING ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO SENDING THE ACCOUNT TO COLLECTION. IF DURING THE COURSE OF THE COLLECTION PROCESS THE COLLECTION AGENCY DETERMINES AN ACCOUNT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, IT IS REFERRED BACK TO THE HOSPITAL FOR FURTHER DISCUSSION WITH THE PATIENT OR FOR WRITE OFF. ALL FURTHER COLLECTION ACTION IS CEASED. PART VI, LINE 2: GOOD SHEPHERD HEALTH CARE SYSTEM HAS PARTNERED WITH ST. ANTHONY HOSPITAL, UMATILLA COUNTY HEALTH DEPARTMENTS, AND OREGON CHILD DEVELOPMENT COALITION, AND CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO CONDUCT AN UMATILLA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. OUR COMMUNITY HEALTHCARE NEEDS ASSESSMENT PROCESS HAS FIVE COMPONENTS THAT ARE CONDUCTED EVERY THIRD YEAR:1. THE ONGOING COLLECTION AND EVALUATION OF COMMUNITY FEEDBACK FROM PATIENT SURVEYS AND COMMENT FORMS.2. PATIENT AND COMMUNITY MEMBER HEALTHCARE NEEDS FOCUS GROUPS.3. A HEALTHCARE NEEDS SURVEY COMPLETED BY EMPLOYERS AND OTHER COMMUNITY LEADERS.4. A FORMAL TELEPHONE SURVEY.5. A DEMOGRAPHIC STUDY CONDUCTED BY THE OREGON OFFICE OF RURAL HEALTH.HARD COPIES OF THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE UPON REQUEST WITHOUT CHARGE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://WWW.GSHEALTH.ORG/COMMUNITYBENEFITHARD COPIES OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH IMPLEMENTATION PLAN IS AVAILABLE UPON REQUEST WITHOUT CHARGE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL:HTTP://WWW.GSHEALTH.ORG/COMMUNITYBENEFIT PART VI, LINE 3: OUR FINANCIAL COUNSELORS INFORM AND EDUCATE THE PEOPLE WE SERVE WITH RESPECT TO CHARITY CARE AND GOVERNMENTAL ASSISTANCE PROGRAMS. ALL PATIENTS AND RESPONSIBLE PARTIES, WHERE POSSIBLE, ARE APPRISED OF THE AVAILABILITY OF FINANCIAL COUNSELING SERVICES AT THE TIME AND POINT OF SERVICE. WE HAVE ARRANGED OUR PATIENT FLOW TO MAXIMIZE THE CONVENIENCE OF VISITING OUR FINANCIAL COUNSELORS AS PART OF THE GOOD SHEPHERD TREATMENT REGIME. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS PROVIDED IN WRITING TO THE PATIENTS UPON REQUEST, AND WHEN THE HOSPITAL IS ABLE TO IDENTIFY A POTENTIAL FAP ELIGIBLE INDIVIDUAL UPON ADMISSIONS. PART VI, LINE 4: GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) IS THE CORPORATE NAME FOR AN ORGANIZATION MADE UP OF SEVERAL ENTITIES, INCLUDING GOOD SHEPHERD MEDICAL CENTER, VANGE JOHN MEMORIAL HOSPICE, GOOD SHEPHERD HOME HEALTH, GOOD SHEPHERD MEDICAL GROUP, AND GOOD SHEPHERD CLINIC PHARMACY. GOOD SHEPHERD SERVES A CORE POPULATION OF ALMOST 50,000 PEOPLE IN THE CITY OF HERMISTON, OREGON AND IN 14 OUTLYING SMALLER TOWNS WITHIN A ROUGH 50-MILE RADIUS. THIS POPULATION IS LARGELY RURAL, WITH AGRICULTURE DOMINATING INDUSTRIAL ENTERPRISES. THE AVERAGE HOUSEHOLD INCOME IN HERMISTON IS 35,865. 17.1% OF RESIDENTS HAVE INCOMES BELOW FEDERAL POVERTY GUIDELINES. 31.3% OF RESIDENTS IDENTIFY AS NONWHITE HISPANIC ETHNICITY, WITH A SIZABLE NUMBER OF SPANISH PRIMARY SPEAKERS. PART VI, LINE 5: GOOD SHEPHERD MAINTAINS OPEN, ACTIVE, AFFILIATE, AND COURTESY MEDICAL STAFFS, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED AND INTERESTED PHYSICIANS IN THE COMMUNITIES WE SERVE. GSHCS IS GOVERNED BY A TWELVE MEMBER BOARD OF TRUSTEES. THE BOARD IS COMPRISED OF INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WITH AN EMPHASIS ON MAINTAINING A TRUE CROSS-SECTION OF CORE POPULATION COMMUNITIES WITHIN ITS MEMBERSHIP. OUR SURPLUS FUNDS ARE USED TO FUND COMMUNITY HEALTH EDUCATION CLASSES, AS WELL AS FUNDING BUILDING AND EQUIPMENT UPGRADES TO MAINTAIN THE HIGHEST QUALITY HEALTHCARE FOR OUR COMMUNITY. SURPLUS FUNDS ARE ALSO APPLIED TO ONGOING PROFESSIONAL EDUCATION AMONG OUR CLINICAL STAFF TO REMAIN CURRENT IN THE BEST PRACTICES OF MODERN HEALTHCARE.WE OPERATE A FULLY STAFFED 24-HOUR EMERGENCY ROOM, AVAILABLE TO THE PUBLIC REGARDLESS OF ABILITY TO PAY.WE LIVE OUR MISSION TO PROMOTE A HEALTHY COMMUNITY. GOOD SHEPHERD IS THE HOST AND DRIVING FORCE BEHIND THE GOOD SHEPHERD WELLNESS COALITION, A GRASSROOTS GROUP OF COMMUNITY LEADERS THAT IDENTIFY, ANALYZE, AND ADDRESS PRESSING HEALTHCARE ISSUES IN THE COMMUNITY.WE MAINTAIN A DIALOGUE WITH THE PEOPLE WE SERVE THROUGH A BIWEEKLY RADIO SHOW, WITH AN EMPHASIS ON WELLNESS AND PREVENTATIVE CARE.GOOD SHEPHERD HOSTS AN ANNUAL FAMILY HEALTH AND FITNESS DAY, WITH FREE ACCESS TO HEALTHCARE PROFESSIONALS, FREE SCREENINGS, AND A WEALTH OF HEALTH AND WELLNESS INFORMATION AVAILABLE TO THE PUBLIC.WE ARE ACTIVE IN COMMUNITY HEALTH RELATED ACTIVITIES, INCLUDING THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, THE MARCH OF DIMES' MARCH FOR BABIES, AND THE UMATILLA COUNTY FAIR, WHERE WE PROVIDE HEALTH INFORMATION AND HEALTHCARE RELATED GIVEAWAYS. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION 610 NW 11TH STREET HERMISTON OR 97838 931170546 501(C)(3) 176608 0 FINANCIAL SUPPORT BLUE MOUNTAIN COMMUNITY COLLEGE 975 SE COLUMBIA DRIVE HERMISTON OR 97838 930506536 GOV 40000 0 NURSING PROGRAM 2 0 SCHOLARSHIPS 4 9313 PART I, LINE 2: REQUESTS FOR FINANCIAL ASSISTANCE ARE APPROVED BY THE BOARD PRIOR TO DISBURSEMENT. ANY ORGANIZATION RECEIVING AN AWARD MUST SIGN AN AGREEMENT BEFORE THE FUNDS ARE DISPERSED STATING THE FUNDS WILL BE USED FOR THE STATED PURPOSE AS LISTED IN THEIR GRANT APPLICATION. GRANTS AWARDED TO GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION, A RELATED ORGANIZATION WHICH IS TAX EXEMPT UNDER SECTION 501(C)(3), ARE REQUIRED TO SUBMIT REGULAR REPORTS UNTIL ALL FUNDS HAVE BEEN SPENT. THESE REPORTS ARE REVIEWED AT THE FOUNDATION MEETINGS OF WHICH BOARD MEMBERS WHO SERVE ON BOTH THE HOSPITAL AND THE FOUNDATION BOARDS ATTEND. THERE ARE NO REPORTING REQUIREMENTS REQUIRED TO BE SENT TO THE HOSPITAL FROM THE OTHER ORGANIZATIONS LISTED ON SCHEDULE I. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 ANN RUST SURGEON 1000280 0 29468 0 0 0 0 0 0 0 1029748 0 0 0 DAVID MACCABEE SURGEON 826947 0 15500 0 0 0 0 0 0 0 842447 0 0 0 JAMES WHITTUM ORTHOPEDIC SURGEON 808971 0 21386 0 0 0 35952 0 22719 0 889028 0 0 0 JEREMY ANDERSON ORTHOPEDIC SURGEON 794799 0 17630 0 0 0 37182 0 21995 0 871606 0 0 0 CHRISTOPHER SCOTT CHIROPRACTIC PRACTITIONER 722224 0 31760 0 0 0 28889 0 13428 0 796301 0 0 0 BRIAN SIMS CEO (THRU JAN 2023) 368359 0 50000 0 19500 0 18300 0 43109 0 499268 0 0 0 JAN PETER CHIEF FINANCIAL OFFICER 275037 0 23294 0 12652 0 26153 0 28888 0 366024 0 0 0 EMMETT SCHUSTER INTERIM CEO (FROM FEB 2023) 0 0 0 0 297640 0 0 0 0 0 297640 0 0 0 JIM SCHLENKER CHIEF OPERATING OFFICER 256766 0 21682 0 12195 0 12195 0 26842 0 329680 0 0 0 PART I, LINE 1A HOUSING AND ALLOWANCE, ANN RUST, INCLUDED IN TAXABLE COMPENSATION. HOUSING AND ALLOWANCE, DAVID MACCABEE, INCLUDED IN TAXABLE COMPENSATION. HOUSING AND ALLOWANCE, EMMETT SCHUSTER, NOT IN TAXABLE COMPENSATION. PART I, LINE 7 AT THE END OF THE FISCAL YEAR THE BOARD DETERMINES THE AMOUNT OF FUNDS THAT WILL BE DISBURSED FOR BONUSES BASED ON THE ACHIEVEMENT OF SPECIFIED GOALS. MANAGEMENT THEN DETERMINES THE PERCENTAGE OF BONUSES ALLOCATED TO EACH LEVEL AND EACH INDIVIDUAL. THE HOSPITAL MAY ALSO PAY THE CEO A DISCRETIONARY ANNUAL BONUS IN AN AMOUNT TO BE DETERMINED BY THE BOARD OR COMMITTEE BASED UPON THE CEO'S ANNUAL REVIEW. NANCY MABRY BOARD MEMBER 388510 COLLECTIONS SERVICE 0 PART IV, LINE 1: CREDITS INC. IS A COLLECTION SERVICE AGENCY USED BY GSHCS WHICH IS CONTROLLED 100% BY A BOARD MEMBER. FORM 990, PART VI, SECTION A, LINE 2 THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS), A RELATED ORGANIZATION AND HAS A BUSINESS RELATIONSHIP WITH THE FOLLOWING COMMON BOARD MEMBERS OF GSHCS AND THE FOUNDATION: TOM WAMSLEY, BILL ELFERING AND LISA MITTLESDORF. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CFO AND CONTROLLER WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES WITH CONFLICTS ARE EXPECTED TO DISCLOSE CONFLICTS OF INTEREST ON A VOLUNTARY BASIS AND REFRAIN FROM DISCUSSION AND/OR VOTING ON RELATED MATTERS AS NECESSARY. THESE DISCLOSURES ARE REVIEWED AND DETERMINED TO EXIST OR NOT TO EXIST BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS BASED ON SURVEY INFORMATION. THIS PROCESS IS COMPLETED ANNUALLY IN THE MONTH OF OCTOBER. THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED BY THE CEO BASED ON SURVEY INFORMATION. THIS PROCESS IS COMPLETED ANNUALLY ON THE ANNIVERSARY DATE OF THE INDIVIDUAL'S HIRE DATE. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 37,001,102. MANAGEMENT AND GENERAL EXPENSES 2,707,540. FUNDRAISING EXPENSES 16,540. TOTAL EXPENSES 39,725,182. 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