MID-COLUMBIA MEDICAL CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- MID-COLUMBIA MEDICAL CENTER (EIN 93-0386936)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-10-26
- IRS object ID
- 202023009349300762
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-10-26T08:57:11-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930386936 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MID- | BusinessNameControlTxt |
| Phone | 5412961111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WENDY APLAND | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5412961111 | PhoneNum |
| Signature | 2020-10-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2020-10-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 184.100.239.163 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-10-13 | IPDt |
| IP Tm | 15:08:04 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7D2FE2EA17AC540A2D29D4112E82844D375299C1 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENNIS KNOX | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $137,021,775 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCMC.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET; TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE; TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1073 | TotalEmployeeCnt |
| Total Volunteers | 232 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $37,462 | PYContributionsGrantsAmt |
| CY Contributions Grants | $49,748 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $130,679,352 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $133,371,578 | CYProgramServiceRevenueAmt |
| PY Investment Income | $823,050 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,349,894 | CYInvestmentIncomeAmt |
| PY Other Revenue | $575,986 | PYOtherRevenueAmt |
| CY Other Revenue | $250,555 | CYOtherRevenueAmt |
| PY Total Revenue | $132,115,850 | PYTotalRevenueAmt |
| CY Total Revenue | $137,021,775 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $877,607 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $614,974 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $69,334,403 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $74,255,798 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $58,600,787 | PYOtherExpensesAmt |
| CY Other Expenses | $61,113,337 | CYOtherExpensesAmt |
| PY Total Expenses | $128,812,797 | PYTotalExpensesAmt |
| CY Total Expenses | $135,984,109 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,303,053 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,037,666 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $63,130,359 | TotalAssetsBOYAmt |
| Total Assets EOY | $66,067,234 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,450,683 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,919,766 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $33,679,676 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $37,147,468 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET; TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE; TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $128,674,967 | ExpenseAmt |
| Grant | $614,974 | GrantAmt |
| Revenue | $133,100,903 | RevenueAmt |
| Desc | ACUTE HOSPITAL CARE:INPATIENT DAYS 6,499, INPATIENT REHAB DAYS 783, OUTPATIENT OBSERVATION DAYS 1,599, LABORATORY TESTS 214,424, IMAGING TESTS 30,706, HOME HEALTH EPISODES 2,026, EMERGENCY VISITS 15,060, ENDOSCOPY VISITS 1,875, MEDICAL ONCOLOGY 9,605, OUTPAIENT SURGERIES 1,518, RADIATION ONCOLOGY OUTPATIENT PROCEDURES 7,162, TOTAL HOSPITAL OUTPATIENT VISITS 102,878 AND TOTAL OUTPATIENT CLINIC VISITS 88,123.SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS. | Desc |
| Total Program Service Expenses | $128,674,967 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 124 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1073 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WENDY APLAND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5412961111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DENNIS KNOX | |||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | Yes (X) | $635,212 | $0 | $29,891 | |
| KEITH STELZER | |||||||
| PHYSICIAN | 40.00 | $542,103 | $0 | $42,496 | Yes (X) | ||
| GARY GINGRICH | |||||||
| PHYSICIAN | 40.00 | $466,343 | $0 | $31,290 | Yes (X) | ||
| LARRY KAHL - TERMED | |||||||
| COO | 40.00 | Yes (X) | $424,134 | $0 | $29,767 | ||
| NATHAN ULLRICH | |||||||
| PHYSICIAN | 40.00 | $394,642 | $0 | $33,215 | Yes (X) | ||
| MARC MCALLISTER | |||||||
| PHYSICIAN | 40.00 | $385,618 | $0 | $41,255 | Yes (X) | ||
| DONG XIANG | |||||||
| PHYSICIAN | 40.00 | $359,848 | $0 | $34,047 | Yes (X) | ||
| DAVID STURGEON - TERMED | |||||||
| CFO | 40.00 | Yes (X) | $353,614 | $0 | $24,320 | ||
| SERENE PERKINS | |||||||
| CMO | 40.00 | Yes (X) | $324,901 | $0 | $27,206 | ||
| PAUL CARDOSI MD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $309,631 | $0 | $35,955 | ||
| DONALD WENZLER | |||||||
| CNO | 40.00 | Yes (X) | $243,472 | $0 | $27,954 | ||
| DALE LEPPER | |||||||
| CIO | 40.00 | Yes (X) | $226,907 | $0 | $12,095 | ||
| WENDY APLAND | |||||||
| CFO | 40.00 | Yes (X) | $74,961 | $0 | $4,351 | ||
| EDWIN BODE | |||||||
| INTERIM CFO | 40.00 | Yes (X) | $73,777 | $0 | $2,223 | ||
| WALLACE WOLF JR DVM | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CARINA SCHMIDT | |||||||
| VICE-CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DANIEL BOLDT | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PHIL BRADY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK TODA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL HILL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHELE SPATZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,815,163 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $376,065 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 109 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ADAMS CONSTRUCTION | |||||
| 1215 E 18TH STREET | THE DALLES | OR | 97058 | CONSTRUCTION OF IMMEDIATE CARE FACILITY | $439,307 |
| PATRICK GRIMSLEY DO PC | |||||
| 2880 BEAR RIDGE DR | HOOD RIVER | OR | 97031 | ER PHYSICIAN | $316,251 |
| ROSONKE MEDICAL GROUP PC | |||||
| 4125 STONEGATE DR | HOOD RIVER | OR | 97031 | ER PHYSICIAN GROUP | $309,715 |
| JOHN ELLIOTT MD | |||||
| 1027 LINCOLN ST | HOOD RIVER | OR | 97031 | ER PHYSICIAN | $302,579 |
| WILLIAM BRAD FARRIS MD | |||||
| 905 STATE ST | HOOD RIVER | OR | 97031 | ER PHYSICIAN | $258,483 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $49,748 | GovernmentGrantsAmt |
| Total Contributions | $49,748 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621500 | $106,981,692 | $106,981,692 | |
| PHARMACY REVENUE | 446110 | $24,478,655 | $24,478,655 | |
| FITNESS & SPA CENTER | 713940 | $1,390,001 | $1,390,001 | |
| CAFETERIA | 900099 | $521,230 | $521,230 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $133,371,578 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $552,051 | TotalRevenueColumnAmt |
| Exclusion | $552,051 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,797,843 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,797,843 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,797,843 | TotalRevenueColumnAmt |
| Exclusion | $2,797,843 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $250,555 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $250,555 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $250,555 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,021,775 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $133,100,903 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,871,124 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $614,974 | TotalAmt |
| Program Services | $614,974 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,531 | TotalAmt |
| Program Services | $623,531 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,971,499 | TotalAmt |
| Program Services | $58,047,928 | ProgramServicesAmt |
| Management And General | $2,923,571 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,491,483 | TotalAmt |
| Program Services | $2,390,545 | ProgramServicesAmt |
| Management And General | $100,938 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,991,843 | TotalAmt |
| Program Services | $5,975,787 | ProgramServicesAmt |
| Management And General | $16,056 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,177,442 | TotalAmt |
| Program Services | $4,020,464 | ProgramServicesAmt |
| Management And General | $156,978 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,253 | TotalAmt |
| Management And General | $150,253 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,724 | TotalAmt |
| Program Services | $99,724 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,957,329 | TotalAmt |
| Program Services | $18,261,355 | ProgramServicesAmt |
| Management And General | $2,695,974 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,950 | TotalAmt |
| Program Services | $380,950 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,076,019 | TotalAmt |
| Program Services | $5,592,317 | ProgramServicesAmt |
| Management And General | $483,702 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,095,417 | TotalAmt |
| Program Services | $2,021,958 | ProgramServicesAmt |
| Management And General | $73,459 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,586,868 | TotalAmt |
| Program Services | $5,522,331 | ProgramServicesAmt |
| Management And General | $64,537 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,713 | TotalAmt |
| Program Services | $300,730 | ProgramServicesAmt |
| Management And General | $70,983 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,892 | TotalAmt |
| Program Services | $188,212 | ProgramServicesAmt |
| Management And General | $50,680 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $521,766 | TotalAmt |
| Program Services | $521,766 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,884,033 | TotalAmt |
| Program Services | $4,647,004 | ProgramServicesAmt |
| Management And General | $237,029 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $729,955 | TotalAmt |
| Program Services | $708,221 | ProgramServicesAmt |
| Management And General | $21,734 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES EXPENS | $14,572,582 | $14,570,849 | $1,733 |
| REPAIRS & MAINTENANCE | $2,351,579 | $2,301,868 | $49,711 |
| DUES & SUBSCRIPTIONS | $219,404 | $81,472 | $137,932 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,876,853 | TotalAmt |
| Program Services | $1,802,981 | ProgramServicesAmt |
| Management And General | $73,872 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,984,109 | TotalAmt |
| Program Services | $128,674,967 | ProgramServicesAmt |
| Management And General | $7,309,142 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,741 | BOYAmt |
| EOY | $6,008,264 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,913,418 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,983,255 | BOYAmt |
| EOY | $17,746,909 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,962,303 | BOYAmt |
| EOY | $1,877,376 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,406,985 | BOYAmt |
| EOY | $1,491,740 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $77,805,452 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $56,050,075 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,771,840 | BOYAmt |
| EOY | $21,755,377 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,266,866 | BOYAmt |
| EOY | $12,566,995 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,410,669 | BOYAmt |
| EOY | $1,410,669 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,401,282 | BOYAmt |
| EOY | $3,209,904 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,130,359 | BOYAmt |
| EOY | $66,067,234 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,281,154 | BOYAmt |
| EOY | $14,642,562 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,706 | BOYAmt |
| EOY | $180,336 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,646,349 | BOYAmt |
| EOY | $11,018,265 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,372,474 | BOYAmt |
| EOY | $3,078,603 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,450,683 | BOYAmt |
| EOY | $28,919,766 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,756,724 | BOYAmt |
| EOY | $34,969,288 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,922,952 | BOYAmt |
| EOY | $2,178,180 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,679,676 | BOYAmt |
| EOY | $37,147,468 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,130,359 | BOYAmt |
| EOY | $66,067,234 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,037,666 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,430,126 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $79,841 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $79,841 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | 2019 OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS DUES $58,643; 2019 AMERICAN HOSPITAL ASSOCIATION DUES $21,198 | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $622,933 | OtherCostOrOtherBasisAmt |
| Book Value | $622,933 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,523,081 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,013,461 | DepreciationAmt |
| Book Value | $4,509,620 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,902,661 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,485,953 | DepreciationAmt |
| Book Value | $3,416,708 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,289,526 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,463,661 | DepreciationAmt |
| Book Value | $11,825,865 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,467,251 | OtherCostOrOtherBasisAmt |
| Depreciation | $87,000 | DepreciationAmt |
| Book Value | $1,380,251 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,755,377 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| MALPRACTICE LIABILITY - IBNR | $670,052 |
| POST-RETIREMENT BENEFIT | $1,389,656 |
| DUE TO RELATED PARTIES | $1,018,895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,078,603 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $137,159,943 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $138,168 | OtherRevenueAmt |
| Revenue Not Reported | $138,168 | RevenueNotReportedAmt |
| Revenue Subtotal | $137,021,775 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $137,021,775 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $135,369,135 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $135,369,135 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $614,974 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $614,974 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $135,984,109 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 138,168. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | TRANSFERS TO FOUNDATION 614,974. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,185,313 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,185,313 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,955,908 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,211,245 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,744,663 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02750 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,141,221 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,211,245 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,929,976 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 16 | ActivitiesOrProgramsCnt |
| Persons Served | 3707 | PersonsServedCnt |
| Total Community Benefit Expns | $277,280 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $277,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 64 | PersonsServedCnt |
| Total Community Benefit Expns | $375,297 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $375,297 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 269 | PersonsServedCnt |
| Total Community Benefit Expns | $7,392 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,392 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,596 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $250 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,346 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,297,580 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,297,580 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 4040 | PersonsServedCnt |
| Total Community Benefit Expns | $1,964,145 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $250 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,963,895 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 4040 | PersonsServedCnt |
| Total Community Benefit Expns | $19,105,366 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,211,495 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,893,871 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05060 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $150,118 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $150,118 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 180 | PersonsServedCnt |
| Total Community Benefit Expns | $174,373 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $174,373 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 180 | PersonsServedCnt |
| Total Community Benefit Expns | $324,491 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $324,491 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,528,856 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $36,029,202 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $39,534,417 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,505,215 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH STREET | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MCMC.NET | WebsiteAddressTxt |
| State License | 14-0500 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.MCMC.NET | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | 0 | ImplementationStrategyAdoptInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.MCMC.NET | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.MCMC.NET | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.MCMC.NET | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 CENTERAL 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 11: THE NEXT COMMUNITY HEALTH IMPROVEMENT PLAN THROUGH COLUMBIA GORGE HEALTH COUNCIL IS SLATED FOR COMPLETION IN THE SUMMER OF 2020, THIS WILL HELP GUIDE MID-COLUMBIA MEDICAL CENTER'S INDIVIDUALIZED IMPLEMENTATION PLAN. |
| 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - WATER'S EDGE MEDICAL CLINIC | ||||
| 551 LONE PINE BLVD SUITE 201 | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 2 - MCMC FAMILY MEDICINE | ||||
| 1620 E 12TH STREET | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 3 - COLUMBIA CREST MEDICAL CLINIC | ||||
| 1935 E 19TH STREET | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 4 - COLUMBIA RIVER WOMEN'S CENTER | ||||
| 1810 E 19TH STREET SUITE 209 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 5 - MCMC SURGICAL CLINIC | ||||
| 1810 E 19TH STREET SUITE 225 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 6 - GORGE UROLOGY | ||||
| 1805 E 19TH STREET | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 7 - MCMC SPECIALTY CLINICS AT NICHOLS LANDIN | ||||
| 33 NICHOLS PARKWAY | HOOD RIVER | OR | 97031 | NON-HOSPITAL BASED CLINIC |
| 8 - MCMC OCCUPATIONAL HEALTH | ||||
| 1815 E 19TH STREET SUITE 2 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 9 - MCMC SPECIALTY CLINICS AT WOODS COURT | ||||
| 1619 WOODS COURT | HOOD RIVER | OR | 97031 | NON-HOSPITAL BASED CLINIC |
| 10 - COLUMBIA GORGE ENT AND ALLERGY | ||||
| 1815 E 19TH STREET SUITE 1 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COST-TO-CHARGE RATIO WAS UTILIZED; CCR WAS DERIVED FROM CALCULATION USED IN 2019 MEDICARE COST REPORT. |
| PART I, LINE 7G: | COSTS INCLUDE $4,551 FOR SOMOS MIGRANT OUTREACH CLINIC AND $2,841 WAS FOR WOMEN'S AND CHILDREN'S SERVICES FOR A TOTAL OF $7,392. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MCMC PROMOTES THE HEALTH OF THE COMMUNITES 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 (INJURED STUDENTS). |
| 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, 2019 AND 2018, 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: | COMMUNITY 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 IN ORDER TO CAPTURE AND RANK THE PRIMARY PERCEIVED NEEDS IN THE GORGE REGION. OVERALL NEEDS IDENTIFIED WERE ADEQUATE INCOME, STABLE HOUSING, FOOD, TRANSPORTATION AND HEALTH PREVENTION AND BOTH MEDICAL AND BEHAVIORAL HEALTH. ACCESS TO CARE WAS AN ADDITIONAL REGION WIDE IDENTIFIED ISSUE. THE NEXT COMMUNITY HEALTH IMPROVEMENT PLAN THROUGH CGHC IS SLATED FOR COMPLETION IN THE SUMMER OF 2020, THIS WILL HELP GUIDE MCMC'S INDIVIDUALIZED IMPLEMENTATION PLAN.MANY HEALTH OUTCOMES AND FACTORS REMAINED STEADY FROM THE 2016 ASSESSMENT TO 2019, OF PARTICULAR CONCERN IN WASCO COUNTY INCLUDE A HIGH RATE OF CHRONIC DISEASE, PREVALENCE OF ADULT AND CHILD OBESITY, TEEN PREGNANCY, LIMITED ACCESS TO HEALTHY FOODS, DENTAL CARE AND AFFORDABLE HOUSING, HIGH SCHOOL GRADUATION RATE AND A RELATIVELY HIGH PERCENTAGE OF THE POPULATION REPORTING INADEQUATE SOCIAL SUPPORT. |
| 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 PROGRAM. |
| PART VI, LINE 4: | MID-COLUMBIA MEDICAL CENTER (MCMC) IS LOCATED IN THE DALLES, WASCO COUNTY, OREGON, WITH THE POPULATION OF WASCO COUNTY AT 26,505. 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 STATE FOR A COMBINED POPLUATION TOTAL OF 52,214. MEDIAN INCOMES AND ETHNIC DEMOGRAPHICS VARY BY GEOGRAPHIC LOCATION. 2018 CENSUS DATA SHOW MEDIAN INCOME RANGE FROM $42,976 TO $50,973.WASCO COUNTY HAS THE LARGEST ETHNIC DIVERSITY WITH A DISTRIBUTION THAT IS 74% WHITE, 19% HISPANIC/LATINO, 4% AMERICAN INDIAN/ALASKA NATIVE AND 4% OTHER, STATISTICS WHICH REMAIN RELATIVELY UNCHANGED FROM 2014. FOURTEEN PERCENT OF THE POPULATION LIVES BELOW THE POVERTY LEVEL AND 11% OF THE POPULATION UNDER THE AGE OF 65 IS UNINSURED. 2019 DATA FROM THE OREGON HEALTH AUDITORY CITES MARCH 2019 MEDICAID PROGRAM ENROLLMENT IN WASCO COUNTY AT 7,778, AND 9,843 AT DECEMBER 2018, AN INCREASE OF 21%.IN ADDITION TO THE YEAR ROUND POPULATION, THE DALLES EXPERIENCES AN INFLUX OVER 15,000 SEASONAL WORKERS IN SUPPORT OF THE HARVEST OF OUR AGRICULTURAL ECONOMY. |
| PART VI, LINE 5: | MID-COLUMBIA MEDICAL CENTER IS A MISSION-DRIVEN ORGANIZATION WHOSE PURPOSE IS: TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE MET ENTHUSIASTICALLY TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE LIVE TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTHCARE 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 COMMUNITY BENEFIT COMMITTEE 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 IN ORDER TO CAPTURE AND RANK THE PRIMARY PERCEIVED NEEDS IN THE GORGE REGION. OVERALL NEEDS IDENTIFIED WERE ADEQUATE INCOME, STABLE HOUSING, FOOD, TRANSPORTATION AND HEALTH PREVENTION AND BOTH MEDICAL AND BEHAVIORAL HEALTH. ACCESS TO CARE WAS AN ADDITIONAL REGION WIDE IDENTIFIED ISSUE. THE NEXT COMMUNITY HEALTH IMPROVEMENT PLAN THROUGH CGHC IS SLATED FOR COMPLETION IN THE SUMMER OF 2020, THIS WILL HELP GUIDE MCMC'S INDIVIDUALIZED IMPLEMENTATION PLAN.MANY HEALTH OUTCOMES AND FACTORS REMAINED STEADY FROM THE 2016 ASSESSMENT TO 2019, OF PARTICULAR CONCERN IN WASCO COUNTY INCLUDE A HIGH RATE OF CHRONIC DISEASE, PREVALENCE OF ADULT AND CHILD OBESITY, TEEN PREGNANCY, LIMITED ACCESS TO HEALTHY FOODS, DENTAL CARE AND AFFORDABLE HOUSING, HIGH SCHOOL GRADUATION RATE AND A RELATIVELY HIGH PERCENTAGE OF THE POPULATION REPORTING INADEQUATE SOCIAL SUPPORT. PREVENTION AND EDUCATIONADULT AND CHILDHOOD OBESITY-MID-COLUMBIA MEDICAL CENTER PARTNERS WITH THOSE IN THE COMMUNITY SEEKING TO IMPROVE OR ENHANCE THEIR HEALTH THROUGH LIFESTYLE CHANGES AND CHOICES, PARTICULARLY IN THE AREAS OF OBESITY AND HEART DISEASE. -FREE COMMUNITY EDUCATION LECTURES FEATURING THE FOLLOWING TOPICS: -HPV & STI'S IN TEENS -NUTRITION & PAIN MANAGEMENT -TOTAL JOINT REPLACEMENTS -FALL PREVENTION -COPING WITH THE BLUESPATIENT REHABILITATION SERVICES, CENTER FOR MIND BODY MEDICINE -PATIENT REHABILITATION SERVICES PROVIDED COMMUNITY EDUCATION AND ASSISTANCE IN THE DECISION-MAKING PROCESS FOR COMMUNITY MEMBERS CONSIDERING TOTAL JOINT REPLACEMENT -39 PARTICIPANTS ATTENDED THE 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. THE PROGRAM ALSO ADDRESSES BABY SIGN LANGUAGE AND DEVELOPMENT, PELVIC HEALTH FOR MOTHERS, BABY-MOTHER BONDING AND LACTATION SUPPORT. MOMMY WELLNESS TARGETS LOW INCOME, MINORITY AND UNDER-SERVED WOMEN AND THEIR YOUNG CHILDREN -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 HAD 20 ATTENDEES WITH THE CLASS 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 OFFERED -CENTER FOR MIND BODY MEDICINE OFFERED MONTHLY MINDFULNESS MEDITATION AND BREATH CLASSES THROUGHOUT THE YEAR, WITH FOCUS ON LOWERING STRESS AND ANXIETY THROUGH MEDITATION AND BREATHING. FURTHER GOALS TO HELP RESHAPE THE RELATIONSHIP WITH MENTAL AND PHYSICAL PAIN AND REDUCE 'BRAIN CHATTER.' THESE CLASSES WERE FREE TO THE COMMUNITYPOVERTY 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 PROGRAMOTHER MEANINGFUL CONTRIBUTIONS IN THE YEAR 2019 -MCMC FACILITATES A VARIETY OF SUPPORT GROUPS ON A REGULAR BASIS, INCLUDINGO MONTHLY STROKE CLUB O MONTHLY FAMILY SUPPORT CLASSES O PARKINSON'S SUPPORT GROUP O PRE- OR BORDERLINE DIABETES CLASSO SURVIVORSHIP (POST-CANCER) SUPPORT GROUP -CAR SEAT EVALUATIONS AND FREE BIKE HELMETS AND FITTINGS ARE AVAILABLE YEAR-ROUND THROUGH OUR EMERGENCY DEPARTMENT -MCMC PROVIDES 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 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 THE AMERICAN RED CROSS BLOOD DRIVES -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.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, HIGH SCHOOL DROP-OUT RATES, TEEN PREGNANCY, HOUSING AND TRANSPORTATION. THE HOSPITAL ALSO PARTICIPATES AS A MEMBER OF THE COLUMBIA GORGE HEALTH COUNCIL (CGHC) 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 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH ST | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 930854433 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $614,974 | CashGrantAmt |
| Purpose Of Grant | OPPERATIONAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | OPERATIONAL SUPPORT IS BASED OF THE GENERAL LEDGER & SUPPORTING JOURNAL ENTRIES MAINTAINED MID-COLUMBIA MEDICAL CENTER ON BEHALF OF THE FOUNDATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENNIS KNOX | ||||||||||||||
| PRESIDENT & CEO | $481,682 | $0 | $150,562 | $0 | $2,968 | $0 | $14,000 | $0 | $15,891 | $0 | $665,103 | $0 | $0 | $0 |
| KEITH STELZER | ||||||||||||||
| PHYSICIAN | $542,103 | $0 | $0 | $0 | $0 | $0 | $13,950 | $0 | $28,546 | $0 | $584,599 | $0 | $0 | $0 |
| GARY GINGRICH | ||||||||||||||
| PHYSICIAN | $466,343 | $0 | $0 | $0 | $0 | $0 | $14,000 | $0 | $17,290 | $0 | $497,633 | $0 | $0 | $0 |
| LARRY KAHL - TERMED | ||||||||||||||
| COO | $221,529 | $0 | $18,936 | $0 | $183,669 | $0 | $13,477 | $0 | $16,290 | $0 | $453,901 | $0 | $0 | $0 |
| NATHAN ULLRICH | ||||||||||||||
| PHYSICIAN | $302,892 | $0 | $0 | $0 | $91,750 | $0 | $13,950 | $0 | $19,265 | $0 | $427,857 | $0 | $0 | $0 |
| MARC MCALLISTER | ||||||||||||||
| PHYSICIAN | $385,618 | $0 | $0 | $0 | $0 | $0 | $14,000 | $0 | $27,255 | $0 | $426,873 | $0 | $0 | $0 |
| DONG XIANG | ||||||||||||||
| PHYSICIAN | $359,848 | $0 | $0 | $0 | $0 | $0 | $14,000 | $0 | $20,047 | $0 | $393,895 | $0 | $0 | $0 |
| DAVID STURGEON - TERMED | ||||||||||||||
| CFO | $179,816 | $0 | $15,339 | $0 | $158,459 | $0 | $10,660 | $0 | $13,660 | $0 | $377,934 | $0 | $0 | $0 |
| SERENE PERKINS | ||||||||||||||
| CMO | $305,819 | $0 | $0 | $0 | $19,082 | $0 | $14,000 | $0 | $13,206 | $0 | $352,107 | $0 | $0 | $0 |
| PAUL CARDOSI MD | ||||||||||||||
| DIRECTOR | $309,631 | $0 | $0 | $0 | $0 | $0 | $14,000 | $0 | $21,955 | $0 | $345,586 | $0 | $0 | $0 |
| DONALD WENZLER | ||||||||||||||
| CNO | $222,584 | $0 | $15,296 | $0 | $5,592 | $0 | $12,163 | $0 | $15,791 | $0 | $271,426 | $0 | $0 | $0 |
| DALE LEPPER | ||||||||||||||
| CIO | $210,105 | $0 | $13,824 | $0 | $2,978 | $0 | $11,222 | $0 | $873 | $0 | $239,002 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | THE INCENTIVE COMPENSATION PLAN FOR THE QUALIFIED PERSON WAS BASED LARGELY ON NET PROFESSIONAL FEES GENERATED DIRECTLY BY THE QUALIFIED PERSON, COMMON PRACTICE FOR EMPLOYED PHYSICIANS. |
| PART I, LINE 6 | THERE IS AN INCENTIVE BASED COMPENSATION PLAN FOR THE EXECUTIVE TEAM BUT IT IS BASED ON MORE THAN JUST FINANCIAL RESULTS. |
| PART I, LINE 7 | EXECUTIVES IDENTIFIED RECEIVED INCENTIVE PAY IN JULY 2019 EARNED FOR 2018 GOAL ACHIEVEMENT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | HEALTH CARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. ON APRIL 4, 2019, THE OPERATIONS AND RELATED ASSETS AND LIABILITIES OF HEALTH CARE FOR THE MID-COLUMBIA REGION WERE MERGED INTO MID-COLUMBIA MEDICAL CENTER. AS A RESULT, MID-COLUMBIA MEDICAL CENTER WILL EXIST AS THE PARENT OVER THE AFFILIATES OF THE FOUNDATION AND DRY HOLLOW. NO CHANCE TO THE OVERALL SCOPE OF OPERATIONS OCCURRED AS A RESULT OF THIS EVENT. |
| 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 WAS DESIGNED WHICH INCLUDED 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 | AS REQUESTED. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,317,773. MANAGEMENT AND GENERAL EXPENSES 2,695,974. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,013,747. PROFESSIONAL FEES AND CONSULTING: PROGRAM SERVICE EXPENSES 11,943,582. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,943,582. |
| FORM 990, PART XI, LINE 9: | NET ASSETS TRANSFERRED FROM AFFILIATES 2,430,126. |
| FORM 990, PART XI, LINE 2C | THE RESPONSIBILITY AND PROCESS FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MID-COLUMBIA HEALTH FOUNDATION | ||||||||||
| PO BOX 1580 | THE DALLES | OR | 97058 | 930854433 | SUPPORT MID-COLUMBIA MEDICAL CENTER | OR | 501(C)(3) | LINE 7 | HEALTH CARE FOR THE MID-COLUMBIA REGION | Yes (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 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LONE PINE HEALTH & WELLNESS CENTER LLC | |||||||||||
| 10210 194TH STREET E101 | GRAHAM | WA | 98338 | 263919508 | MANAGE MEDICAL BUILDING/PROPERTY | OR | EXCLUDED 512-514 | 0 | 0 | 0.30000 | |
| LPH&WC HOLDINGS LLC | |||||||||||
| 1524 SHERMAN AVENUE | HOOD RIVER | OR | 97031 | 811236711 | RENTAL ACTIVITY | OR | UNRELATED | 0 | 0 | 0.50000 | MID-COLUMBIA MEDICAL CENTER |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRY HOLLOW PROFESSIONAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930631350 | EIN |
| Primary Activities | RENTAL BUILDING | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| DRY HOLLOW PROFESSIONAL CENTER | ||
| E | $198,230 | ACTUAL |
| LONE PINE HEALTH & WELLNESS CENTER | ||
| K | $1,890,000 | ACTUAL |
| DRY HOLLOW PROFESSIONAL CENTER | ||
| K | $141,546 | ACTUAL |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| P | $614,974 | ACTUAL |
| LPH&WC HOLDINGS LLC | ||
| D | $820,666 | ACTUAL |
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