2022-11-08T12:04:31-06:00 2021-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2021-01-01 930386936 MID-COLUMBIA MEDICAL CENTER MID- 5412961111 PO BOX 1580 THE DALLES OR 97058 WENDY APLAND CFO 5412961111 2022-11-07 1 WENDY APLAND 999009999 TERRI REXRODE CPA MST P00096513 9206620016 2022-11-02 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DENNIS KNOX PO BOX 1580 THE DALLES OR 97058 145541722 0 X WWW.MCMC.NET X 1944 OR SEE SCH O. 11 9 1111 120 0 0 59312 4174996 139255435 140757811 320380 576486 0 300 139635127 145509593 332016 232670 0 0 76198069 79909130 0 0 0 57259735 63820124 133789820 143961924 5845307 1547669 85881695 81790157 42975644 37456844 42906051 44333313 X SEE SCH O 0 0 137357144 232670 140324929 ACUTE HOSPITAL CARE:INPATIENT DAYS 7,505, INPATIENT REHAB DAYS 546, OUTPATIENT OBSERVATION DAYS 1,069, LABORATORY TESTS 211,405, IMAGING TESTS 32,824, HOME HEALTH EPISODES 2,119, EMERGENCY VISITS 13,198, ENDOSCOPY VISITS 1,286, MEDICAL ONCOLOGY 7,739, OUTPATIENT SURGERIES 1,520, RADIATION ONCOLOGY 6,830, SAME DAY PROCEDURES 1,825, TOTAL HOSPITAL OUTPATIENT VISITS 95,614, AND TOTAL OUTPATIENT CLINIC VISITS 87,940.SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS. 137357144 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 108 0 1111 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X WENDY APLAND 5412961111 PO BOX 1580 THE DALLES OR 97058 DENNIS KNOX PRESIDENT & CEO 40.00 1.00 X X 567010 0 29923 PHIL BRADY CHAIR 1.00 X X 0 0 0 JANET HAMADA SECRETARY 1.00 X X 0 0 0 PAUL CARDOSI MD DIRECTOR 40.00 X 317422 0 34920 BILL KETCHUM DIRECTOR 1.00 X 0 0 0 ANTHONY MASCIOTRA DIRECTOR (THRU DEC) 1.00 X 0 0 0 VICTOR MONDRAGON DIRECTOR 1.00 X 0 0 0 JOE ROBERTSON MD DIRECTOR (THRU JULY) 1.00 X 0 0 0 MICHELE SPATZ DIRECTOR 1.00 X 0 0 0 FRANK TODA DIRECTOR 1.00 X 0 0 0 ROBB VAN CLEAVE DIRECTOR 1.00 X 0 0 0 WALLACE WOLF JR DVM DIRECTOR (THRU DEC) 1.00 X 0 0 0 SERENE PERKINS MD CMO 40.00 X 342328 0 30045 DON WENZLER CCO 40.00 X 314742 0 29473 WENDY APLAND CFO 40.00 X 320663 0 32353 DALE LEPPER CIO 40.00 X 246579 0 12704 CAMIE OVERTON COO 40.00 X 121745 0 6581 CHERI MCCALL CHRO 40.00 X 130284 0 17820 DOUGLAS BEAMAN PHYSICIAN 40.00 X 592764 0 32520 SOPHIA BORNSTEIN PHYSICIAN 40.00 X 530300 0 23234 GARY GINGRICH PHYSICIAN 40.00 X 439242 0 30723 BRIAN SCRIVENS PHYSICIAN 40.00 X 631688 0 32520 JEFFREY MATHISEN PHYSICIAN 40.00 X 444005 0 32520 4998772 0 345336 123 0 1 0 OXFORD ANESTHESIA MANAGEMENT LLC 1765 E NINE MILE ROAD SUITE 1-229 PENSACOLA FL 32514 ANESTHESIA SERVICES 1001137 CSS STAFFING LLC 17216 SATICOY STREET UNIT 366 LAKE BALBOA CA 91406 CONSULTING SERVICES 399286 PETER F STOLOFF PC 5285 MEADOWS ROAD SUITE 235 LAKE OSWEGO OR 97035 LEGAL SERVICES 245879 TRIAGE LLC 12020 PACIFIC STREET OMAHA NE 68154 TEMPORARY STAFFING 198779 ROSS K GOLDBERG 5600 HIDDEN GLEN COURT WESTLAKE VILLAGE CA 91362 PUBLIC RELATIONS SERVICES 118707 8 230846 3944150 4174996 NET PATIENT SERVICE REVENUE 621500 102885264 102885264 PHARMACY REVENUE 446110 37204872 37204872 CAFETERIA 722514 432882 432882 FITNESS CENTER 713940 234793 234793 140757811 608615 608615 32129 -32129 -32129 -32129 300 300 300 145509593 140324929 0 1009668 X 232670 232670 2554593 1197256 1357337 63482408 62568667 913741 2460871 2327125 133746 7230369 7108877 121492 4180889 3915403 265486 539326 148992 390334 85500 85500 21894058 20383817 1510241 242652 242578 74 1717719 1657393 60326 4393845 3915795 478050 5378943 4929512 449431 269836 245825 24011 153071 151106 1965 404769 404769 4674126 4247557 426569 1075661 1022091 53570 MEDICAL SUPPLIES 19831161 19829040 2121 REPAIRS & MAINTENANCE 2163487 2132623 30864 DUES & SUBSCRIPTIONS 271464 127652 143812 TAXES & LICENSES 65542 54316 11226 658964 514080 144884 143961924 137357144 6604780 0 15999676 11595333 14879665 10427209 15051493 20958344 1857368 1892260 1364994 1624790 70110358 52044961 20222452 18065397 12340134 12953351 1160669 1088535 3005244 3184938 85881695 81790157 18659609 14115763 2849972 3574273 9300652 8497088 12165411 11269720 42975644 37456844 X 41472642 43644676 1433409 688637 42906051 44333313 85881695 81790157 X 1547669 -286035 165628 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13488 13488 0 PART II-B, LINE 1: 2021 OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS DUES $7,709; 2021 AMERICAN HOSPITAL ASSOCIATION DUES $5,779 622933 622933 18870142 14974983 3895159 7366681 4242549 3124132 41428182 32740429 8687753 1822420 87000 1735420 18065397 POST-RETIREMENT BENEFIT 872261 DUE TO RELATED PARTIES 285161 MEDICARE ACCELERATED PAYMENTS 9424237 CAPITAL LEASE OBLIGATIONS 688061 11269720 X PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE MEDICAL CENTER 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 1 0 1 1 2664749 2664749 0.01850 25156984 16285817 8871167 0.06160 27821733 16285817 11535916 0.08010 9 503245 43299 459946 0.00320 1 301571 301571 0.00210 1 6046173 4213385 1832788 0.01270 8215 8215 0.00010 11 6859204 4256684 2602520 0.01810 11 34680937 20542501 14138436 0.09820 1 1098 1098 0.00000 4 100 80411 80411 0.00060 5 100 81509 81509 0.00060 1 45343 38887734 42314278 -3426544 X 1 1 1 1 MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 HTTP://WWW.MCMC.NET/ABOUT-MCMC/COMMUNI 14-0500 X X X MID-COLUMBIA MEDICAL CENTER 1 0 0 1 X X X X X X X 19 1 1 1 1 X SEE SCHEDULE H, SECTION C, LINE 7D X HTTPS://WWW.CGHEALTHCOUNCIL.ORG/ X 1 20 1 SEE SCHEDULE H, SECTION C, LINE 7D 0 1 X 200.000000000000 400.000000000000 X 1 1 X X X 1 X HTTPS://MCMC.NET/FOR-PATIENTS-GUESTS/BILLING-AND-FINANCIAL-INFORMATION/ X HTTPS://MCMC.NET/FOR-PATIENTS-GUESTS/BILLING-AND-FINANCIAL-INFORMATION/ X HTTPS://MCMC.NET/FOR-PATIENTS-GUESTS/BILLING-AND-FINANCIAL-INFORMATION/ X X X X X X X 1 X 0 X X X X 1 X 0 0 MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 5: MID-COLUMBIA MEDICAL CENTER PARTICIPATED AS A MEMBER OF THE COLUMBIA GORGE HEALTH COUNCIL (CGHC) IN A COLLABORATIVE NEEDS ASSESSMENT IN 2019 WHICH INCLUDED INPUT FROM SIX COUNTY HEALTH DEPARTMENTS, FOUR HOSPITALS, THE LOCAL COORDINATED CARE ORGANIZATION, SOCIAL SERVICES AGENCIES IN THE REGION, HEALTH CARE PROVIDERS IN THE SERVICE REGION AND CONSUMER'S REPRESENTATIVE OF THE SAME. MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 6A: MID-COLUMBIA MEDICAL CENTER, KLICKITAT VALLEY HEALTH, PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL, SKYLINE HOSPITAL MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 6B: COLUMBIA GORGE HEALTH COUNCIL, HOOD RIVER COUNTY HEALTH DEPARTMENT, KLICKITAT COUNTY HEALTH DEPARTMENT, MID-COLUMBIA CENTER FOR LIVING, NORTH CENTRAL PUBLIC HEALTH DISTRICT, ONE COMMUNITY HEALTH, PACIFIC SOURCE COMMUNITY SOLUTIONS, SKAMANIA COUNTY HEALTH DEPARTMENT, FOUR RIVERS EARLY LEARNING HUB, UNITED WAY, ADVANTAGE DENTAL, EASTERN OREGON CCO, SOUTHWEST ACCOUNTABLE COMMUNITIES OF HEALTH MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 7D: SCHEDULE H, PART V, SECTION B, LINES 7A & LINE 10A:HTTPS://WWW.CGHEALTHCOUNCIL.ORG/CHA-CHIP MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 11: NEEDS WERE IDENTIFIED THROUGH THE COMMUNITY HEALTH ASSESSMENT AND THE CUMULATIVE HEALTH DATA GATHERED. NEEDS THAT WORSENED OVER TIME OR WERE POORER THAN THE STATE AND/OR NATIONAL AVERAGE WERE PRIORITIZED ALONG WITH NEEDS THAT DISPROPORTIONATELY AFFECTED VULNERABLE POPULATIONS.COMMUNITY HEALTH IMPROVEMENT PLAN PRIORITIESTHE IDENTIFIED TOP FOCUS AREAS THROUGHOUT THE SEVEN-COUNTY REGION ARE: HOUSING. FOOD. TRANSPORTATION AND MOBILITY. EQUITABLE HEALTH CARE SERVICES. EQUITABLE PHYSICAL ACTIVITY. SOCIAL CONNECTION AND COMMUNICATION. CHILDREN AND YOUTH SAFETY.THE FULL CHIP CAN BE ACCESSED HERE: HTTPS://STATIC1.SQUARESPACE.COM/STATIC/5E7109F83CFF1B7D10E22DA6/T/5F121C8CD72BC729C955C2C9/1595022476435/COLUMBIA+GORGE+REGIONAL+2020+CHIP+PRIORITIES+SUMMARY-+ENGLISH.PDFIN RESPONSE, THE MCMC COMMUNITY BENEFIT COMMITTEE IN ALIGNMENT WITH OUR MISSION AND VISION HAS SET THE FOLLOWING FOCUS PRIORITIES FOR THE 2020-2022 COMMUNITY BENEFIT CYCLE:PRIORITY 1: ACCESS TO EQUITABLE HEALTH CARE SERVICESFOCUS ON PROVIDING NAVIGATION AND COORDINATION FOR PRIMARY CARE, SPECIALTY CARE AND MENTAL HEALTH SERVICES. PROVIDE TIMELY CARE TO PATIENTS WHEN AND WHERE THEY NEED IT. ENSURE PATIENTS HAVE AFFORDABLE AND ADEQUATE INSURANCE COVERAGE.COMMUNITY NEED ADDRESSED ACCESS TO PRIMARY, SPECIALTY, AND BEHAVIORAL HEALTH CARE.GOAL (ANTICIPATED IMPACT)INCREASED ACCESSIBILITY FOR TIMELY CARE; INCREASED PATIENT ESTABLISHMENT WITH PCP; INCREASED NAVIGATION AND SUPPORTIVE SERVICES TO VULNERABLE POPULATIONS; INCREASED ACCESS TO CLINIC BASED BEHAVIORAL HEALTH SERVICES.PRIORITY 2: SOCIAL DETERMINANTS OF HEALTHADDRESS THESE BARRIERS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO:TRANSPORTATION, AFFORDABLE HOUSING, AND FOOD INSECURITY.COMMUNITY NEED ADDRESSEDACCESS TO HEALTHY FOOD/FOOD INSECURITY.GOAL (ANTICIPATED IMPACT)INCREASED ACCESS TO HEALTHY FOODS TO VULNERABLE PATIENT POPULATION, OPEN ELIGIBILITY BEYOND DIABETIC PATIENTS.PRIORITY 3: PATIENT EMPOWERING EDUCATIONFOCUS ON PROVIDING EDUCATION TO HELP PATIENTS MAKE INFORMED AND EMPOWERED DECISIONS REGARDING THEIR HEALTH AND WELLNESS INCLUDING PAIN MANAGEMENT, NUTRITION, HEALTHY LIVING, AND CHRONIC DISEASE PREVENTION.COMMUNITY NEED ADDRESSEDPROVIDING ACCESS TO INFORMATION AND EDUCATION ON WELLNESS, HEALTH PROMOTION AND DISEASE PREVENTION. OFFERING FREE EDUCATIONAL OPPORTUNITIES TO ALLOW THE COMMUNITY ACCESS TO A VARIETY OF HEALTH CARE TOPICS, GIVING THEM THE INFORMATION TO MAKE EMPOWERED DECISIONS ABOUT THEIR OWN WELL-BEING.GOAL (ANTICIPATED IMPACT)PEOPLE RECEIVE THE LANGUAGE-APPROPRIATE INFORMATION THEY NEED OR WANT ON PAPER, ONLINE OR VIDEO TO BE ABLE TO ACCESS THE SERVICES THEY NEED.CONTINUED EFFORTSMANY OF THE KEY IDENTIFIED NEEDS FROM THE PREVIOUS CHA REMAINED, IN RESPONSE, MCMC HAS MAINTAINED THE FOLLOWING COMMUNITY BENEFIT PROGRAMS AND ACTIVITIES.WORKED CLOSELY WITH OUR LOCAL SCHOOL DISTRICT TO BOTH ASSESS IDENTIFIED NEEDS AND PROMOTE EQUITY IN PHYSICAL ACTIVITY TO HELP ADDRESS THE VARIOUS HEALTH ISSUES FACED BY TODAY'S YOUTH. THIS INCLUDES IDENTIFYING ALL PHYSICAL ACTIVITY OPPORTUNITIES OF LOCAL YOUTH AND PINPOINTING DISPARITIESIN WHICH TO FOCUS OUR EFFORTS.PROVIDED FREE ATHLETIC TRAINING SERVICES TO EIGHT LOCAL MIDDLE AND HIGH SCHOOLS. OUR FREE SERVICES INCLUDE INJURY PREVENTION, TRIAGE, REHABILITATION, AND CONCUSSION CARE. OUR FIVE FULL-TIME STAFF MEMBERS DEDICATE THEIR ENTIRE WORKLOAD TO KEEPING STUDENT ATHLETES AT THESE SCHOOLS SAFE AND HEALTHY THROUGH THE YEAR-ROUND SPORTS SEASON.PROVIDED SCHOOL NURSING SERVICES AT LOCAL SCHOOLS.OFFERED NUTRITION PROGRAMS THAT PROVIDE IN-DEPTH SUPPORT AND EDUCATION FOR DIABETES AND DIABETES PREVENTION AS WELL AS FACILITATING SUPPORT GROUPS FOR WEIGHT MANAGEMENT AND PROVIDING COMMUNITY EDUCATION ON VARIOUS NUTRITIONAL TOPICS.HELD FREE MOMMY WELLNESS CLASSES INTERDISCIPLINARY PROGRAM FOR PREGNANT AND NEW MOTHERS WITH CHILDREN UP TO 2 YEARS OF AGE TO PROVIDE EDUCATION AND EXERCISE TO PROMOTE HEALTHY LIFESTYLE HABITS FOR MOTHER AND CHILD. MOMMY WELLNESS TARGETS LOW-INCOME, MINORITY AND UNDERSERVED WOMEN AND THEIR YOUNG CHILDREN.OFFERED YEAR-ROUND, FREE CAR SEAT AND BIKE HELMET EVALUATIONS AND FITTINGS THROUGH OUR EMERGENCY DEPARTMENT.PROVIDED MENTORING AND INTERNSHIP PROGRAMS DESIGNED TO HELP TRAIN EXISTING AND FUTURE CARE PROVIDERS SUCH AS PHARMACY TECHNICIANS, EMS TECHNICIANS, MEDICAL ASSISTANTS, HEALTH INFORMATION MANAGEMENT STUDENTS, CHILDCARE PROVIDERS, RADIOLOGICAL TECHNICIANS, NURSES AND RURAL HEALTHPROVIDERS.FACILITATED A VARIETY OF SUPPORT GROUPS ON A REGULAR BASIS.PROVIDED FREE MEETING FACILITIES FOR VARIOUS CHARITABLE, CIVIC AND SUPPORT GROUPS.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMPROVIDED FUNDING FOR YOUTH ACTIVITY GROUPS: SPORTS/ ROBOTICS/NON-PROFITS TO ALLOW COMMUNITY CHILDREN EXPANDED COMMUNITY EXPERIENCES SOME IDENTIFIED NEEDS FALL OUTSIDE OF THE SCOPE OF MCMC'S HEALTHCARE PRACTICE. WHILE MCMC ITSELF IS UNABLE TO ADDRESS THESE, OUR STAFF IS WORKING COLLABORATIVELY WITH COMMUNITY PARTNERS TO ACKNOWLEDGE THE NEED AND DEVELOP ACTION PLANS FOR DENTAL CARE AND ADDITIONAL FOCUS ON HOUSING MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 16J: MCMC CHARGES AND A LINK TO OUR FINANCIAL ASSISTANCE POLICY ARE AVAILABLE ON THE OREGON PRICEPOINT WEBSITE: HTTP://WWW.ORPRICEPOINT.ORG HOSTED BY THE OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS. THE POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. 9 1 - WATER'S EDGE MEDICAL CLINIC 551 LONE PINE BLVD THE DALLES OR 97058 RURAL HEALTH CLINIC 2 - MCMC FAMILY MEDICINE 1620 E 12TH STREET THE DALLES OR 97058 RURAL HEALTH CLINIC 3 - COLUMBIA CREST MEDICAL CLINIC 1935 E 19TH STREET THE DALLES OR 97058 RURAL HEALTH CLINIC 4 - COLUMBIA RIVER WOMEN'S CENTER 1810 E 19TH STREET SUITE 209 THE DALLES OR 97058 RURAL HEALTH CLINIC 5 - MCMC SURGICAL CLINIC 1810 E 19TH STREET SUITE 225 THE DALLES OR 97058 OUTPATIENT CLINIC 6 - MCMC SPECIALTY CLINICS AT NICHOLS LANDIN 33 NICHOLS PARKWAY HOOD RIVER OR 97031 OUTPATIENT CLINIC 7 - GORGE UROLOGY 1805 E 19TH STREET THE DALLES OR 97058 OUTPATIENT CLINIC 8 - MCMC OCCUPATIONAL HEALTH 1825 E 19TH STREET SUITE 2 THE DALLES OR 97058 OUTPATIENT CLINIC 9 - COLUMBIA GORGE ENT AND ALLERGY 1815 E 19TH STREET SUITE 1 THE DALLES OR 97058 OUTPATIENT CLINIC PART I, LINE 7: COST-TO-CHARGE RATIO WAS UTILIZED; CCR WAS DERIVED FROM CALCULATION USED IN THE 2021 MEDICARE COST REPORT. PART I, LINE 7G: EM PHYSICIAN ADVISORY PART II, COMMUNITY BUILDING ACTIVITIES: MCMC PROMOTES THE HEALTH OF THE COMMUNITIES WE SERVE BY PARTICIPATING IN REGIONAL EMERGENCY PREPAREDNESS PROGRAMS (PANDEMIC, NATURAL DISASTERS, AREA AND STATE TRAUMA ADVISORY BOARDS) AND DRILLS; BY SERVING AS AN ADVOCATE FOR THE COMMUNITY WITH REGARD TO LOCAL, STATE-WIDE AND REGIONAL HEALTH INITIATIVES; ACTING IN ADVISORY CAPACITY WITH OTHER LOCAL, STATE, AND REGIONAL ORGANIZATIONS IN ORDER TO CREATE, ACCESS AND PROVIDE SERVICES OTHERWISE NOT AVAILABLE TO THE COMMUNITY; WORKING WITH THE LOCAL COMMUNITY COLLEGE AND EMS TO EDUCATE AND TRAIN FUTURE HEALTHCARE WORKERS BY PROVIDING JOB SHADOWING AND MENTORING PROGRAMS AS WELL AS DONATED SUPPORT TO THE COLLEGE FOR SPECIFIC NURSING PROGRAMS AND PROVIDING IN-KIND STAFF DONATED HOURS TO LOCAL SCHOOL ATHLETIC FUNCTIONS IN A MEDICAL CAPACITY (PREVENTING AND TREATING STUDENT INJURIES). PART III, LINE 2: DESCRIBES ALLOWANCE FOR BAD DEBT EXPENSE AT GROSS CHARGE. THE ESTIMATE IS BASED PRIMARILY ON THE MEDICAL CENTER'S HISTORICAL COLLECTION EXPERIENCE, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY AND THE EFFECTIVENESS OF COLLECTIONS EFFORTS. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019, BAD DEBT EXPENSE WAS INSIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS AND WAS NOT DISCRETELY PRESENTED.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (INCLUDING BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: MEDICARE COST REPORT COST TO CHARGE RATIO METHODOLOGY IS USED TO DETERMINE THE ALLOWABLE MEDICARE COSTS. MID-COLUMBIA MEDICAL CENTER CONTINUES TO PROVIDE CLINICAL SERVICES TO MEDICARE PATIENTS AT A DEFICIT AS PART OF OUR COMMITMENT TO THE RESIDENTS OF THE COMMUNITIES WE SERVE. THIS DEFICIT IS CONSISTENT WITH OUR TAX-EXEMPT STATUS AND INTERNAL MISSION TO PROVIDE COMMUNITY BASED HEALTHCARE REGARDLESS OF PATIENTS' ABILITY TO PAY. PART III, LINE 9B: IN CASES WHERE THE PATIENT HAS QUALIFIED FOR FULL OR PARTIAL CHARITY CARE, THE AMOUNT IS WRITTEN DOWN IN THE PATIENT ACCOUNT AND NO ATTEMPT IS MADE TO COLLECT THE AMOUNT WRITTEN DOWN. PART VI, LINE 2: IN ADDITION TO PARTICIPATING IN THE COLLABORATIVE CHNA, MCMC TAKES ACTIVE EFFORTS TO PARTICIPATE IN NUMEROUS COMMUNITY PARTNERSHIPS FOCUSED ON SOCIAL DETERMINANTS OF HEALTH SUCH AS CHRONIC HOMELESSNESS, MENTAL HEALTH, CHILDHOOD OBESITY AND TRANSPORTATION. PARTICIPATION IN THESE GROUPS HELP GAIN A MORE COMPREHENSIVE UNDERSTANDING OF OUR COMMUNITY AND THE ROOT CAUSES OF THOSE HEALTH ISSUES AS WELL AS THE AVAILABILITY OF RESOURCES TO ADDRESS THEM. MCMC ACTIVELY INTEGRATES HEALTH EFFORTS WITH OTHER KEY COMMUNITY LEADERS, INCLUDING PUBLIC HEALTH AND NORTHERN WASCO COUNTY SCHOOL DISTRICT TO IDENTIFY AND ADDRESS HEALTH ISSUES WITH PROGRAMS SUCH AS OUR SCHOOL NURSES AND ATHLETIC TRAINERS. THE PARTNERSHIPS WERE OF CRITICAL VALUE DURING THE PANDEMIC IN WHICH WE RELIED HEAVILY ON THESE RELATIONSHIPS TO IDENTIFY AND RAPIDLY RESPOND TO COVID RELATED INCIDENTS. THROUGHOUT 2021 MCMC STAFF ALSO PARTICIPATED IN NUMEROUS EMERGENCY MANAGEMENT AND COVID TASK FORCES TO ASSESS AND ADDRESS THE RAPIDLY EVOLVING PANDEMIC.INTERNALLY, MCMC HOSTS A PATIENT AND FAMILY ADVISORY COUNCIL TO GATHER DIRECT INPUT ON THE NEEDS, CONCERNS, AND EXPERIENCES OF OUR PATIENTS FOR THE ADVANCEMENT OF QUALITY PATIENT CARE. PART VI, LINE 3: OUR PATIENT AND VISITOR SERVICES STAFF TAKE AN ACTIVE ROLE IN ASSISTING LOW-INCOME AND UNDER- / UN-INSURED PATIENTS (THERE ARE SOME EXEMPTIONS IN PLACE TO THE INDIVIDUAL MANDATE REQUIRED BY THE AFFORDABLE CARE ACT) WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. APPLICATIONS (IN ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS IN BOTH THE HOSPITAL AND THE OUTPATIENT CLINICS. THIS APPLICATION PACKET OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION FOR ASSISTANCE WITH ENROLLMENT; STAFF HOURS ARE ALSO ACTIVELY DEDICATED TO ASSISTING IN THE PRESUMPTIVE ELIGIBILITY AND FULL COVERAGE FOR PATIENTS WITH INSURANCE ASSISTANCE. PATIENTS ARE ALSO ASSISTED IN ACHIEVING COMMUNITY RESOURCES THROUGH MCMC EMPLOYMENT OF BRIDGES TO HEALTH PATIENT NAVIGATORS, AND THROUGH REFERRALS TO SCREENING, HOUSING, TRANSPORTATION, FOOD, EDUCATION, AND OTHER NEEDED RESOURCES. PART VI, LINE 4: MID-COLUMBIA MEDICAL CENTER (MCMC) IS LOCATED IN THE DALLES, WASCO COUNTY, OREGON, WITH THE POPULATION OF WASCO COUNTY AT 26,670. MCMC SERVES A WIDE GEOGRAPHIC AREA OF RURAL NORTH CENTRAL OREGON ALONG THE COLUMBIA RIVER. THIS SERVICE AREA INCLUDES WASCO, SHERMAN AND GILLIAM COUNTIES IN OREGON AND KLICKITAT COUNTY IN WASHINGTON FOR A COMBINED POPULATION TOTAL OF 53,270. MEDIAN INCOMES AND ETHNIC DEMOGRAPHICS VARY BY GEOGRAPHIC LOCATION. 2020 CENSUS DATA SHOWS MEDIAN INCOMES RANGE FROM $41,838 TO $56,667. WASCO COUNTY HAS THE LARGEST ETHNIC DIVERSITY WITH A DISTRIBUTION THAT IS 78% WHITE, 19% HISPANIC/LATINO, 4% AMERICAN INDIAN/ALASKA NATIVE AND 4% OTHER, STATISTICS WHICH REMAIN RELATIVELY UNCHANGED FROM 2014. 11% OF THE POPULATION LIVES BELOW THE POVERTY LEVEL AND 8.4% OF THE POPULATION UNDER THE AGE OF 65 IS UNINSURED. DATA FROM THE OREGON HEALTH AUTHORITY CITES DECEMBER 2021 MEDICAID PROGRAM ENROLLMENT IN WASCO COUNTY AT 10,473, UP 7% FROM 9,805 IN DECEMBER 2020.IN ADDITION TO THE YEAR-ROUND POPULATION, THE DALLES EXPERIENCES AN INFLUX OF OVER 15,000 SEASONAL WORKERS EACH YEAR IN SUPPORT OF THE HARVEST OF OUR AGRICULTURAL ECONOMY. PART VI, LINE 5: GIVING BACK TO OUR COMMUNITYMID-COLUMBIA MEDICAL CENTER IS A MISSION-DRIVEN ORGANIZATION WHOSE PURPOSE IS TO PROVIDE EXCEPTIONAL AND AFFORDABLE HEALTHCARE SERVICES AND EXPERIENCES TO THOSE WE ARE PRIVILEGED TO SERVE, THOUGH PERSON-CENTERED CARE.BOARD AND SENIOR EXECUTIVE LEADERSHIP ARE ACTIVELY INVOLVED IN PRIORITIZATION OF COMMUNITY INITIATIVES. A FULL-TIME COORDINATOR OF MCMC'S COMMUNITY INITIATIVES DEPARTMENT OVERSEES IMPLEMENTATION OF PROGRAMS AND ACTS AS THE PRIMARY LIAISON IN COMMUNITY COLLABORATIONS. DISCUSSION AND RECOMMENDATION OF COMMUNITY BENEFIT FOCUS AREAS CENTERS AROUND FIVE KEY COMPONENTS: ALIGNMENT WITH THE ORGANIZATION'S STRATEGIC PLAN; LIKELIHOOD OR FEASIBILITY OF HAVING A MEASURABLE IMPACT ON THE ISSUE; ALIGNMENT WITH CORE ORGANIZATIONAL COMPETENCIES; EFFICIENT ALLOCATION OF RESOURCES AND ALIGNMENT WITH PARTNERS WHO HAVE RESOURCES ALLOCATED TOWARD THE ISSUE. THE MID-COLUMBIA MEDICAL CENTER COMMUNITY BENEFIT COMMITTEE (CBC), FORMED IN 2019, IS AN ADVISORY COMMITTEE FOCUSED ON LEADING COMMUNITY BENEFIT INITIATIVES BOTH INSIDE AND OUTSIDE THE WALLS OF THE HOSPITAL. THESE ACTIVITIES INCLUDE IMPROVING CARE AND ACCESS FOR VULNERABLE POPULATIONS, PROMOTING COMMUNITY HEALTH, AND ENGAGING IN RESEARCH AND EDUCATION AS DRIVEN BY THE COLUMBIA GORGE HEALTH COUNCIL'S COMMUNITY HEALTH ASSESSMENT. MCMC'S CBC CONSISTS OF REPRESENTATION FROM OUR MEDICAL STAFF, NURSING LEADERSHIP, MARKETING AND OUTREACH, FINANCIAL STAFF, OUTPATIENT CLINICS AND OTHER KEY STAFF WHO CONTRIBUTE TO AND INFLUENCE THE OVERALL COMMUNITY BENEFIT OF OUR HOSPITAL. THE CBC IS RESPONSIBLE FOR ENSURING THAT MCMC STRATEGIC PLANS EFFECTIVELY ADDRESS THE SPECIFIC HEALTH NEEDS OF OUR COMMUNITY AS IDENTIFIED THROUGH THE CHA; EXTENDING AND STRENGTHENING MCMC'S PROGRAMS' COMMUNITY BENEFIT SERVICES; AND CHAMPIONING COMMUNITY COLLABORATIONS WITH GOVERNMENT, NONPROFIT, OR OTHER HEALTHCARE RELATED ORGANIZATIONS.NEEDS ASSESSMENTCOMMUNITY BENEFIT PRIORITIES AND ALLOCATIONS ARE GUIDED BY A COMMUNITY ASSESSMENT PROCESS WHICH UTILIZES QUANTITATIVE AND QUALITATIVE DATA OBTAINED FROM INTERNAL SOURCES AS WELL AS ASSESSMENT DATA FROM KEY COMMUNITY PARTNERS. MID-COLUMBIA MEDICAL CENTER PARTICIPATED AS A MEMBER OF THE COLUMBIA GORGE HEALTH COUNCIL (CGHC) IN A COLLABORATIVE NEEDS ASSESSMENT IN 2019 WHICH INCLUDED INPUT FROM SIX COUNTY HEALTH DEPARTMENTS, FOUR HOSPITALS, THE LOCAL COORDINATED CARE ORGANIZATION, SOCIAL SERVICES AGENCIES IN THE REGION, HEALTH CARE PROVIDERS IN THE SERVICE REGION AND CONSUMER'S REPRESENTATIVE OF THE SAME. DETAILS ON THE METHODOLOGY, PARTICIPANTS AND REGIONAL RESULTS ARE ADDRESSED IN THE COLUMBIA GORGE REGIONAL COMMUNITY HEALTH ASSESSMENT AGENCY REPORT AND HEALTH CARE PROFESSIONAL SESSIONS WERE CONDUCTED TO CAPTURE AND RANK THE PRIMARY PERCEIVED NEEDS IN THE GORGE REGION. THE TOP IDENTIFIED DRIVERS FOR THE 2019 CYCLE INCLUDE CHILDREN AND YOUTH SAFETY, STABLE HOUSING, FOOD, TRANSPORTATION, PHYSICAL ACTIVITY, AND HEALTH PREVENTION FOR BOTH MEDICAL AND BEHAVIORAL HEALTH. ACCESS TO CARE HAS REMAINED AS AN ADDITIONAL REGION WIDE IDENTIFIED ISSUE. UNFORTUNATELY, ALL SOCIAL SUPPORT INDICATORS FROM THE CONSUMER SURVEY ARE WORSE THAN 2016. TRANSPORTATION, YOUTH HEALTH AND SAFETY, AND ACCESS TO CHILDCARE ALL SAW DECLINES. MEDICALLY, IMPROVEMENTS WERE SEEN IN ACCESS TO CARE COUPLED WITH A DECREASE IN EMERGENCY ROOM UTILIZATION FOR NON-EMERGENT CARE.PREVENTION AND EDUCATIONADULT AND CHILDHOOD OBESITY MID-COLUMBIA MEDICAL CENTER OFFERS A COMPREHENSIVE WELLNESS PROGRAM FOR PEOPLE COMMITTED TO MAKING LASTING LIFESTYLE CHANGES. PREVENT IS A ONE-YEAR PROGRAM TAUGHT BY A TRAINED LIFESTYLE COACH FOR PEOPLE DIAGNOSED WITH PRE-DIABETES OR HEART DISEASE OR ARE OVERWEIGHT. MCMC IS A PROUD MEMBER OF FIT IN THE GORGE, A COALITION OF COMMUNITY PARTNERS THAT AIMS TO REDUCE CHILDHOOD OBESITY THROUGHOUT THE COLUMBIA GORGE REGION. WE WORK COLLABORATIVELY ACROSS SECTORS INCLUDING HEALTH CARE, PARKS & REC, PUBLIC HEALTH, AND EDUCATION TO FIND CREATIVE SOLUTIONS TO ADDRESS CHILDHOOD OBESITY. OUR PEDIATRICS AND FAMILY MEDICINE PROVIDERS COLLABORATE WITH PARKS & REC TO FACILITATE "SWIM PRESCRIPTIONS" WHICH ARE GIVEN TO FAMILIES OF CHILDREN WHO ARE NOT GETTING ENOUGH PHYSICAL ACTIVITY.PATIENT REHABILITATION SERVICES PATIENT REHABILITATION SERVICES PROVIDED COMMUNITY EDUCATION AND ASSISTANCE IN THE DECISION-MAKING PROCESS FOR COMMUNITY MEMBERS CONSIDERING TOTAL JOINT REPLACEMENT FREE MOMMY WELLNESS CLASSES; AN INTERDISCIPLINARY PROGRAM FOR PREGNANT AND NEW MOTHERS WITH CHILDREN UP TO TWO YEARS OF AGE, ITS PURPOSE IS TO PROVIDE EDUCATION AND EXERCISE DESIGNED TO PROMOTE HEALTHY LIFESTYLE HABITS FOR MOTHER AND CHILD. PERSISTENT PAIN EDUCATION PROGRAM IS AN EIGHT-WEEK CLASS WHICH PROVIDES EDUCATION ON PAIN NEUROSCIENCE, ADAPTIVE COPING STRATEGIES, NUTRITION, MINDFULNESS, PROPER MEDICATION, AND SLEEP HYGIENE TO PEOPLE WHO ARE DEALING WITH CHRONIC PAIN ISSUES. PARKINSON'S SUPPORT GROUP FOCUSING ON RAISING AWARENESS FOR PATIENTS AND CAREGIVERS TO ADVOCATE FOR MAINTAINING INDEPENDENCE ASSISTED LIVING BALANCE CLASS OFFERED TO ALL RESIDENTS OF FLAGSTONE ASSISTED LIVING AND THE DALLES SENIOR CENTER; BALANCE AND FALL RISK SCREENING AND CONSULTATIONS WERE OFFEREDPOVERTY AND UNINSUREDOUR PATIENT AND VISITOR SERVICES STAFF TAKE AN ACTIVE ROLE IN ASSISTING LOW-INCOME AND UNDER- / UN-INSURED PATIENTS (THERE ARE SOME EXEMPTIONS IN PLACE TO THE INDIVIDUAL MANDATE REQUIRED BY THE AFFORDABLE CARE ACT) WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. APPLICATIONS (IN ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS IN BOTH THE HOSPITAL AND THE OUTPATIENT CLINICS. THIS APPLICATION PACKET OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION FOR ASSISTANCE WITH ENROLLMENT; STAFF HOURS ARE ALSO ACTIVELY DEDICATED TO ASSISTING IN THE PRESUMPTIVE ELIGIBILITY AND FULL COVERAGE FOR PATIENTS WITH INSURANCE ASSISTANCE. PATIENTS ARE ALSO ASSISTED IN ACHIEVING COMMUNITY RESOURCES THROUGH MCMC EMPLOYMENT OF BRIDGES TO HEALTH PATIENT NAVIGATORS, AND THROUGH REFERRALS TO SCREENING, HOUSING, TRANSPORTATION, FOOD, EDUCATION, AND OTHER NEEDED RESOURCES. ALL COUNTIES SERVED SHOW A HIGHER THAN NATIONAL AVERAGE OF INDIVIDUALS LIVING WITH DISABILITY AND PERSONS LIVING IN POVERTY. AS TRANSPORTATION AND ACCESS TO CARE REMAIN AT THE TOP OF THE NEEDS LIST FOR OUR VULNERABLE COMMUNITY MEMBERS, MCMC HAS CHOSEN TO CONTINUE TO OFFER VISITING HOME HEALTH SERVICES TO OUR PATIENTS, DESPITE CONTINUED OPERATIONAL LOSSES. MANY IN OUR COMMUNITY LIVE IN REMOTE AREAS AND LACK AVAILABLE, RELIABLE TRANSPORTATION, MAKING OUR VISITING HEALTH SERVICES AN INVALUABLE RESOURCE WHEN PATIENT WOULD BE OTHERWISE UNABLE TO ACCESS NECESSARY MEDICAL CARE. HOME HEALTH SERVICES INCLUDE NURSING, OUTPATIENT THERAPIES, SOCIAL WORKERS, AND AIDS TO ENSURE THE CONTINUUM OF HEALTH AND WELL-BEING FOR THE INDIVIDUAL THROUGH THE COORDINATION AND DELIVERY OF PROFESSIONAL AND COMPASSIONATE ASSESSMENTS, HEALTHCARE SERVICES, AND IN-DEPTH EDUCATION IN THE HOME SETTING. OTHER MEANINGFUL CONTRIBUTIONS IN THE YEAR 2021: CAR SEAT EVALUATIONS AND FREE BIKE HELMETS AND FITTINGS ARE AVAILABLE YEAR-ROUND THROUGH OUR EMERGENCY DEPARTMENT MCMC PROVIDES MENTORING PROGRAMS DESIGNED TO HELP TRAIN EXISTING AND FUTURE CARE PROVIDERS SUCH AS PHARMACY TECHNICIANS, EMS TECHNICIANS, MEDICAL ASSISTANTS, HEALTH INFORMATION MANAGEMENT STUDENTS, CHILDCARE PROVIDERS, RADIOLOGICAL TECHNICIANS, NURSES, AND RURAL HEALTH PROVIDERS PHYSICIANS AND NURSES PROVIDE ACCESS TO FREE OR REDUCED COST PRIMARY CARE; MCMC ALSO PROVIDES SCHOOL NURSING SERVICES AT THE ELEMENTARY AGE LEVEL FOR LOCAL SCHOOLS PROVIDES SUPPORT FOR AND HOSTS BLOOD DRIVES FOR THE AMERICAN RED CROSS ENCOURAGES STAFF TO VOLUNTEER TO MAKE A DIFFERENCE THROUGH SERVICE TO MEMBERS OF THE COMMUNITY PROVIDES FREE MEETING FACILITIES FOR VARIOUS CHARITABLE, CIVIC AND SUPPORT GROUPS MCMC DEVELOPED A PROGRAM CALLED SOMOS: SERVING OREGON AND ITS MIGRANTS BY OFFERING SOLUTIONS. THIS PROGRAM WAS DESIGNED TO ASSIST MIGRANT WORKERS IN OUR COMMUNITY WITH RECEIVING FREE HEALTH SCREENINGS AND REFERRALS AS APPROPRIATE. THE PROGRAM SERVES THE UNDERSERVED MINORITY AND LOW-INCOME MIGRANT POPULATION. PART VI, LINE 5 (CONTINUED): SOCIAL DETERMINANTS OF HEALTHMCMC IS INVOLVED IN A VARIETY OF COMMUNITY AND COALITION BUILDING AND HEALTH ADVOCACY ACTIVITIES REGARDING SUCH SOCIAL DETERMINANTS AS: FOOD AS HEALTH SECURITY, SUBSTANCE ABUSE, MENTAL HEALTH, HOUSING, AND TRANSPORTATION. A STRATEGIC INITIATIVE OF THE ORGANIZATION WAS TO IMPROVE PATIENT NAVIGATION FOR 2021. SOCIAL WORK WAS ADDED TO THE INPATIENT TEAM AND A MULTICULTURAL APPROACH TO OUTREACH WAS ESTABLISHED WITH A DIVERSE TEAM OF PEOPLE WITH BILINGUAL AND BICULTURAL KNOWLEDGE AND LIVED EXPERIENCE. THIS TEAM PREFORMS SOCIAL NEEDS ASSESSMENTS AND ARE A REFERRAL RESOURCE FROM THE HOSPITAL TO CONNECT PATIENTS WITH BARRIERS TO ACCESSING CARE TO NEEDED RESOURCES. THE CASE MANAGEMENT TEAM EVOLVED TO SUPPORT CANCER SCREENING OUTREACH AND EDUCATION, INSURANCE ASSISTANCE, TRANSPORTATION AND HOUSING, SMOKING CESSATION, DIABETES PREVENTION AND DISEASE MANAGEMENT, MIGRANT AND FARM WORKER PROGRAMS, COVID VACCINATION, AND EDUCATION, AS WELL AS CONNECTING PATIENTS TO MANY OTHER COMMUNITY RESOURCES AND PROGRAMS.THE HOSPITAL ALSO PARTICIPATES AS A MEMBER OF THE COLUMBIA GORGE HEALTH COUNCIL (CGHC) AND CLINICAL ADVISORY PANEL (CAP) IN PROVIDING OVERSIGHT AND GOVERNANCE OF THE COORDINATED CARE ORGANIZATION FORMED BY PACIFICSOURCE COMMUNITY SOLUTIONS (PACIFICSOURCE.) CGHC IS A NONPROFIT CORPORATION COMPRISED OF THE MEDICAL CENTER, WASCO AND HOOD RIVER COUNTIES, CENTRAL OREGON INDEPENDENT PRACTICE ASSOCIATION, INC., ONE COMMUNITY HEALTH, PACIFICSOURCE, PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL AND AT-LARGE MEMBERS OF THE COMMUNITY. 1 MID-COLUMBIA HEALTH FOUNDATION 1700 E 19TH ST THE DALLES OR 97058 930854433 501(C)(3) 224342 0 OPERATIONAL SUPPORT 1 0 PART I, LINE 2: OPERATIONAL SUPPORT IS BASED OF THE GENERAL LEDGER & SUPPORTING JOURNAL ENTRIES MAINTAINED BY MID-COLUMBIA MEDICAL CENTER ON BEHALF OF THE FOUNDATION. X 0 1 X X X X X 0 0 0 0 0 0 0 1 0 BRIAN SCRIVENS PHYSICIAN 598610 0 12500 0 20578 0 14500 0 18020 0 664208 0 0 0 DOUGLAS BEAMAN PHYSICIAN 577362 0 15402 0 0 0 14500 0 18020 0 625284 0 0 0 DENNIS KNOX PRESIDENT & CEO 499449 0 67561 0 0 0 14500 0 15423 0 596933 0 0 0 SOPHIA BORNSTEIN PHYSICIAN 527236 0 3064 0 0 0 14500 0 8734 0 553534 0 0 0 JEFFREY MATHISEN PHYSICIAN 439005 0 5000 0 0 0 14500 0 18020 0 476525 0 0 0 GARY GINGRICH PHYSICIAN 423236 0 0 0 16006 0 14500 0 16223 0 469965 0 0 0 SERENE PERKINS MD CMO 323138 0 19190 0 0 0 14500 0 15545 0 372373 0 0 0 WENDY APLAND CFO 302669 0 17994 0 0 0 14500 0 17853 0 353016 0 0 0 PAUL CARDOSI MD DIRECTOR 310210 0 0 0 7212 0 14500 0 20420 0 352342 0 0 0 DON WENZLER CCO 297500 0 17242 0 0 0 14500 0 14973 0 344215 0 0 0 DALE LEPPER CIO 233319 0 13260 0 0 0 12037 0 667 0 259283 0 0 0 PART I, LINE 1B HOUSING ALLOWANCE PROVIDED TO A NEW EXECUTIVE AS A RECRUITMENT INCENTIVE BASED ON A CONTRACT NEGOTIATED AND APPROVED BY THE BOARD COMPENSATION COMMITTEE. PART I, LINE 7 EXECUTIVES RECEIVED INCENTIVE PAY IN 2021 BASED ON 2020 RESULTS. THIS COMPENSATION WAS DETERMINED BY THE BOARD COMPENSATION COMMITTEE BASED ON THE ACHIEVEMENT OF CERTAIN OPERATIONAL AND FINANCIAL GOALS. FORM 990, PART I, LINE 1 MISSION STATEMENT: TO PROVIDE EXCEPTIONAL HEALTH SERVICES AND EXPERIENCES THROUGH PERSON-CENTERED CARE. OUR CORE VALUES: COMPASSION- GROUNDED IN OUR PLANETREE HISTORY, WE DEMONSTRATE EMPATHY FOR PATIENTS, FAMILIES, AND STAFF AND BELIEVE THAT PERSON-CENTERED CARE IS THE CORNERSTONE OF COMPASSION. INTEGRITY- WE PROMOTE TRUST THROUGH OPEN AND RESPECTFUL COMMUNICATION. WE TAKE PRIDE IN WHAT WE DO, FEEL RESPONSIBLE FOR THE OUTCOME OF OUR EFFORTS, AND RECOGNIZE OUR WORK AS A REFLECTION OF OURSELVES. WELLNESS- WE VIEW INDIVIDUALS AS ACTIVE PARTICIPANTS IN THEIR OWN HEALTHCARE AND PARTNER WITH THEM SO THEY CAN ACHIEVE THEIR HIGHEST HEALTH POTENTIAL AND LIVE LIFE TO ITS FULLEST. TEAMWORK- WE RECOGNIZE THAT WE CAN ONLY ACHIEVE OUR MISSION BY WORKING COLLABORATIVELY TO ACHIEVE ORGANIZATIONAL EXCELLENCE AND SUPERIOR PATIENT EXPERIENCES. DIVERSITY, EQUITY, AND INCLUSION PRINCIPLES DRIVE RICH, INNOVATIVE SOLUTIONS TO PATIENT CARE ISSUES. QUALITY- WE STRIVE TO PROVIDE HIGH VALUE HEALTHCARE, DELIVERING EXCELLENT CLINICAL QUALITY WITH A FOCUS ON PATIENT SAFETY AND OUTSTANDING SERVICE. FORM 990, PART III, LINE 1 MISSION STATEMENT: TO PROVIDE EXCEPTIONAL HEALTH SERVICES AND EXPERIENCES THROUGH PERSON-CENTERED CARE. OUR CORE VALUES: COMPASSION- GROUNDED IN OUR PLANETREE HISTORY, WE DEMONSTRATE EMPATHY FOR PATIENTS, FAMILIES, AND STAFF AND BELIEVE THAT PERSON-CENTERED CARE IS THE CORNERSTONE OF COMPASSION. INTEGRITY- WE PROMOTE TRUST THROUGH OPEN AND RESPECTFUL COMMUNICATION. WE TAKE PRIDE IN WHAT WE DO, FEEL RESPONSIBLE FOR THE OUTCOME OF OUR EFFORTS, AND RECOGNIZE OUR WORK AS A REFLECTION OF OURSELVES. WELLNESS- WE VIEW INDIVIDUALS AS ACTIVE PARTICIPANTS IN THEIR OWN HEALTHCARE AND PARTNER WITH THEM SO THEY CAN ACHIEVE THEIR HIGHEST HEALTH POTENTIAL AND LIVE LIFE TO ITS FULLEST. TEAMWORK- WE RECOGNIZE THAT WE CAN ONLY ACHIEVE OUR MISSION BY WORKING COLLABORATIVELY TO ACHIEVE ORGANIZATIONAL EXCELLENCE AND SUPERIOR PATIENT EXPERIENCES. DIVERSITY, EQUITY, AND INCLUSION PRINCIPLES DRIVE RICH, INNOVATIVE SOLUTIONS TO PATIENT CARE ISSUES. QUALITY- WE STRIVE TO PROVIDE HIGH VALUE HEALTHCARE, DELIVERING EXCELLENT CLINICAL QUALITY WITH A FOCUS ON PATIENT SAFETY AND OUTSTANDING SERVICE. FORM 990, PART VI, SECTION A, LINE 4 IN 2021 MCMC TERMINATED ITS CLINICAL COLLABORATION AGREEMENT (CCA) WITH OREGON HEALTH AND SCIENCE UNIVERSITY (OHSU). THAT AGREEMENT HAD INCLUDED PROVISIONS FOR MCMC'S BYLAWS TO BE CHANGED TO REQUIRE AN OHSU REPRESENTATIVE BE A VOTING MEMBER OF THE BOARD AND FOR CERTAIN BOARD ACTIONS TO REQUIRE A SUPER-MAJORITY VOTE INCLUDING THE OHSU REPRESENTATIVE. THE BYLAWS ALSO INCLUDED A PROVISION REMOVING THE CHANGES REQUIRED BY THE CCA IN THE EVENT OF ITS TERMINATION, SO THOSE MEMBERSHIP AND VOTING REQUIREMENTS CEASED UPON THAT EVENT. FORM 990, PART VI, SECTION A, LINE 6 HEALTH CARE FOR THE MID-COLUMBIA REGION EXISTED AS THE SOLE CORPORATE MEMBER OF MID-COLUMBIA MEDICAL CENTER. HCMCF WAS DISSOLVED ON 12/21/21 AND ITS ASSETS TRANSFERRED TO MCMC. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE RETURN IS SUBMITTED TO THE BOARD OF TRUSTEES FOR REVIEW. UPDATES ARE MADE AS NECESSARY BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C WE ANNUALLY REQUIRE ALL OFFICERS AND DIRECTORS TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR AN OFFICER OR DIRECTOR WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE INDIVIDUAL COULD REMAIN AN OFFICER OR DIRECTOR. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION COMMITTEE INCLUDES MEMBERS OF THE BOARD OF TRUSTEES, HR DIRECTOR, AND COMPENSATION SPECIALIST. COMPENSATION COMMITTEE AGED AND/OR UPDATED PREVIOUSLY SUPPLIED COMPENSATION DATA FROM OUTSIDE FIRM BASED ON COMMERCIALLY AVAILABLE SALARY SURVEYS. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS JUST DESCRIBED AND THEN VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS DETERMINED USING A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,912,730. MANAGEMENT AND GENERAL EXPENSES 1,510,241. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,422,971. PROFESSIONAL FEES AND CONSULTING: PROGRAM SERVICE EXPENSES 12,861,838. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,861,838. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 4,454,140. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,454,140. ANESTHESIOLOGSIT FEES: PROGRAM SERVICE EXPENSES 1,155,109. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,155,109. FORM 990, PART XI, LINE 9: CHANGE IN INVESTMENT IN AFFILIATES 165,397. OTHER CHANGES IN NET ASSETS 231. MID-COLUMBIA HEALTH FOUNDATION PO BOX 1580 THE DALLES OR 97058 930854433 SUPPORT MID-COLUMBIA MEDICAL CENTER OR 501(C)(3) LINE 7 MID-COLUMBIA MEDICAL CENTER 1 HEALTH CARE FOR THE MID-COLUMBIA REGION PO BOX 1580 THE DALLES OR 97058 930847905 HEALTH CARE SERVICES OR 501(C)(3) LINE 12C, III - FI 0 DRY HOLLOW PROFESSIONAL CENTER INC PO BOX 1580 THE DALLES OR 97058 930631350 RENTAL BUILDING OR MID-COLUMBIA MEDICAL CENTER C 109649 803516 1.00000 0 0 1 1 1 1 0 0 0 0 0 1 0 1 0 0 1 1 0 1 DRY HOLLOW PROFESSIONAL CENTER E 553764 ACTUAL DRY HOLLOW PROFESSIONAL CENTER K 109649 ACTUAL MID-COLUMBIA HEALTH FOUNDATION B 224342 ACTUAL MID-COLUMBIA HEALTH FOUNDATION C 230846 ACTUAL MID-COLUMBIA HEALTH FOUNDATION S 224603 ACTUAL