2018-11-13T12:02:07-06:00 2017-12-31 930418710 DELAP LLP 5885 MEADOWS ROAD NO 200 LAKE OSWEGO OR 97035 990 2017-01-01 930386936 MID-COLUMBIA MEDICAL CENTER MID- 5412961111 PO BOX 1580 THE DALLES OR 97058 EDWIN BODE CFO 5412961111 2018-11-12 1 MARK E EKLUND CPA P00156145 5036974118 2018-11-12 76.14.192.226 2018-11-12 13:02:30 PS P 9F1C3DA1FA329534A8D887FF2FA26BEF5A992D0B FA70ACD58588B72794AC0476217EF7922E055C68 2017 2019-02-21 02:37:17Z DENNIS KNOX PO BOX 1580 THE DALLES OR 97058 125594290 0 X WWW.MCMC.NET X 1984 OR 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. 7 6 1133 226 0 0 1522014 22732 114984978 115789603 214500 185738 7562279 5512382 124283771 121510455 52506 9100 0 0 74463783 71710584 0 0 297595 56650823 54187101 131167112 125906785 -6883341 -4396330 69676581 62921146 35270131 32367486 34406450 30553660 X 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. 0 0 116192457 9100 119982114 ACUTE HOSPITAL CARE: INPATIENT DAYS 7,348, INPATIENT REHAB DAYS 678, OUTPATIENT OBSERVATION DAYS 1,508, LABORATORY TESTS 204,768, IMAGING TESTS 32,280, HOME HEALTH EPISODES 2,057, EMERGENCY VISITS 15,761, ENDOSCOPY VISITS 1,400, MEDICAL ONCOLOGY 8,908, OUTPATIENT SURGERIES 1,528, RADIATION ONCOLOGY OUTPATIENT PROCEDURES 7,151, TOTAL HOSPITAL OUTPATIENT VISITS 114,187 AND TOTAL OUTPATIENT CLINIC VISITS 81,014.SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS. 116192457 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 141 0 1133 1 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X X MID-COLUMBIA MEDICAL CENTER 5412961111 PO BOX 1580 THE DALLES OR 97058 WALLACE WOLF JR DVM DIRECTOR 1.00 X 0 0 0 CARINA SCHMIDT VICE-CHAIR 1.00 X 0 0 0 PAUL CARDOSI MD SECRETARY 40.00 X 355309 0 34696 DANIEL BOLDT DIRECTOR 1.00 X 0 0 0 PHIL BRADY DIRECTOR 1.00 X 0 0 0 ROB CARNAHAN DIRECTOR, EX-OFFICIO CHAIR 1.00 X 0 0 0 MARK ENGER DIRECTOR 10.00 X 0 0 0 DIANNE STORBY INTERIM CEO 1.00 40.00 X 0 385232 39784 KEITH STELZER PHYSICIAN 40.00 X 634393 0 27539 GARY GINGRICH PHYSICIAN 40.00 X 398071 0 27538 MARC MCALLISTER PHYSICIAN 40.00 X 364609 0 36846 ANALENE PENTOPOULOS PHYSICIAN 40.00 X 340404 0 33046 DENNIS KNOX CEO, EX-OFFICIO DIRECTOR 0.00 40.00 X 0 284025 21749 DUANE FRANCIS EX-OFFICIO DIRECTOR 0.00 X 0 782173 0 DONALD ARBON FORMER - CFO 0.00 X 0 139619 0 EDWIN BODE FORMER - CFO 0.00 X 148800 0 0 2241586 1591049 221198 100 1 1 0 WIPFLI LLP PO BOX 316 MILWAUKIE WI 532013160 CONSULTING 644793 JOHN ELLIOT MD 1027 LINCOLN ST HOOD RIVER OR 97031 ER PHYSICIAN 353639 ROSONKE MEDICAL GROUP 4125 STONEGATE DR HOOD RIVER OR 97031 ER PHYSICIAN GROUP 348845 PATRICK GRIMSLEY 2880 BEAR RIDGE DR HOOD RIVER OR 97031 ER PHYSICIAN 347774 WHITAKER FAMILY LIMITED PARTNERSHIP 3690 SW BROOKLANE DR CORVALLIS OR 97333 LEASE OF MEDICAL BUILDING 277884 27 22732 22732 NET PATIENT SERVICE REVENUE 622110 115789603 115789603 115789603 241000 241000 3648368 380205 3662822 421013 -14454 -40808 -55262 -40808 -14454 PHARMACY SALES 812300 2621649 2621649 FITNESS & SPA CENTER 713940 1106090 1106090 CAFETERIA 722100 757109 757109 1027534 505580 521954 5512382 121510455 119982114 0 1505609 X 9100 9100 1011830 390005 621825 56458955 52739011 3555773 164171 2224173 2065252 151728 7193 8044125 7945533 98247 345 3971501 3698331 261266 11904 1530000 1530000 168995 168995 151554 150591 963 6406 6406 13117909 12927151 113831 76927 205417 198141 3375 3901 498913 434622 55991 8300 4659751 4357796 287984 13971 392207 339808 51478 921 217296 217296 4335312 4205197 130011 104 565402 553963 11236 203 SUPPLIES 25260883 25141270 118070 1543 OTHER 1573322 904802 667777 743 PURCHASED SERVICES 1503734 65179 1438555 125906785 116192457 9416733 297595 4076142 5570333 2252722 2530572 16351961 13482958 447427 188124 102183 1594044 1650779 6530051 5952958 76227760 53185557 25000569 23042203 7549209 6022779 501083 501434 1433768 326965 1592652 1562858 2606256 1727697 69676581 62921146 15655597 13871449 37275 359867 15116229 14660845 4461030 3475325 35270131 32367486 X 28768739 25450326 5637711 5103334 34406450 30553660 69676581 62921146 X -4396330 333145 210395 X X 0 1 X 1 0 X 1387747 209917 60960 14000 1644624 1429254 102815 51758 196080 1387747 1389999 11182 51092 23019 1429254 1345021 8511 48321 11854 1389999 1310867 12621 27470 5937 1345021 0.66360 0.23360 0.10280 0 1 1 562933 562933 15415193 10434459 4980734 4805538 2436230 2369308 53839436 40314868 13524568 1604660 1604660 23042203 IBNR RESERVE 746322 SETTLEMENT RESERVES 1364000 DEFERRED COMPENSATION 1365003 3475325 X 121846288 335833 335833 121510455 0 121510455 125945023 335833 335833 125609190 297595 297595 125906785 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT FUND IS A QUASI-ENDOWMENT THAT FUNDS THE MID-COLUMBIA HEALTH FOUNDATION OPERATING EXPENSES - ENDING BALANCE $1,091,353. THE REMAINING ENDOWMENT FUNDS SUPPORT SEVERAL SCHOLARSHIPS AND OTHER FUNDS EXPLAINED BELOW: TEMPORARY AND PERMANENTLY RESTRICTED FUNDS: - EVELYN KASER SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS WHO ASPIRE TO BECOME REGISTERED NURSES AND INTEND TO PRACTICE THEIR PROFESSION IN THE MID-COLUMBIA REGION. - LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS ASPIRING TO BECOME REGISTERED NURSES WHO GREW UP IN THE MID-COLUMBIA REGION. - MCMC BOARD OF TRUSTEES MEDICAL PROFESSIONALS SCHOLARSHIP: TO HELP DEFRAY SOME COLLEGE EXPENSES FOR GRADUATING SENIORS FROM THE DALLES HIGH SCHOOL. - MASONS LODGE SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS FROM THE LOCAL COMMUNITIES OF SHERMAN, DUFUR AND THE DALLES HIGH SCHOOLS TO ATTEND COLLEGE. - PERMANENT SCHOLARSHIP FUND: EARNS INTEREST THAT IS ANNUALLY TRANSFERRED TO THE MID-COLUMBIA MEDICAL CENTER SCHOLARSHIP FUND. PART X, LINE 2: INCOME TAX POSITIONS THAT MEET A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE MEDICAL CENTER'S BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE MEDICAL CENTER'S STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES FOR MID-COLUMBIA HEALTH FOUNDATION 297,595. 1 1 X 1 X 1 X 1 1 1 0 1 1 3497254 3497254 0.02780 20242814 11548540 8694274 0.06910 23740068 11548540 12191528 0.09690 17 374530 374530 0.00300 3 303972 303972 0.00240 2 7797 7797 0.00010 1 6212 2350 3862 0.00000 7 866737 866737 0.00690 30 1559248 2350 1556898 0.01240 30 25299316 11550890 13748426 0.10930 140252 140252 0.00110 158783 158783 0.00130 299035 299035 0.00240 1 1059287 29576 38183188 38936234 -753046 X 1 1 4 1 MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 WWW.MCMC.NET 14-0500 X X X A 2 WATER'S EDGE MEDICAL CENTER 551 LONE PINE BOULEVARD THE DALLES OR 97058 WWW.MCMC.NET 14-0500-1 X A 3 MCMC OUTPATIENT THERAPY SERVICES AT NICHOL'S LANDING 33 NICHOLS PARKWAY SUITE 350 HOOD RIVER OR 97031 WWW.MCMC.NET 14-0500-4 X A 4 MCMC - ANTI-COAGULATION CLINIC 1935 E 19TH STREET SUITE 110 THE DALLES OR 97058 WWW.MCMC.NET 14-0500-5 X A MID-COLUMBIA MEDICAL CENTER 0 0 1 X X X X X X X 16 1 1 1 1 X HTTP://WWW.MCMC.NET X 1 14 1 HTTP://WWW.MCMC.NET 0 1 X 200.000000000000 400.000000000000 1 1 X X 1 X HTTP://WWW.MCMC.NET X HTTP://WWW.MCMC.NET X HTTP://WWW.MCMC.NET X X X X X X 1 X 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: MID-COLUMBIA MEDICAL CENTER, - FACILITY 2: WATER'S EDGE MEDICAL CENTER, - FACILITY 3: MCMC OUTPATIENT THERAPY SERVICES AT NICHOL'S L, - FACILITY 4: MCMC - ANTI-COAGULATION CLINIC MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 5: IN PREPARING THE CHNA IN 2017, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WE SERVE, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF/EXPERTISE IN PUBLIC HEALTH BY CREATING A COLLABORATIVE, CROSS-ORGANIZATIONAL, CROSS-COUNTY FORUM, THE MEMBERS OF WHICH AGREE ON THE NEEDS WITHIN OUR REGION AND COMMUNITIES AND AGREE TO SUPPORT OUR ABILITY TO ADDRESS THOSE NEEDS TOGETHER. WE ELECTED TO ALSO INCLUDE THE SOCIAL SERVICE AGENCIES AND NON-PROFITS THAT SERVE OUR AREAS' MOST VULNERABLE POPULATIONS.THE PERSONS CONSULTED INCLUDE: BARB SEATTER M.S., JOHN HUFFMAN, DIRECTOR OF COMMUNITY INITIATIVES MID-COLUMBIA MEDICAL CENTER (MCMC), COCO YACKLEY, ELLEN LARSEN RN, ERIN QUINN MSN, FNP, JULIE REYNOLDS PHD, MAIJA YASUI, MARK THOMAS CHAPLAIN, MEGAN MCANINCH MSC, TERI THALHOFER RN, BSN, DIRECTOR NORTH CENTRAL PUBLIC HEALTH DISTRICT. MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 6A: THE HOSPITAL'S (MCMC) CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: KLICKITAT VALLEY HEALTH, PROVIDENCE HOOD RIVER HOSPITAL AND SKYLINE HOSPITAL. MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 6B: THE HOSPITAL'S (MCMC) CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITIES: COLUMBIA GORGE HEALTH COUNCIL, HOOD RIVER COUNTY HEALTH DEPARTMENT, KLICKITAT VALLEY HEALTH DEPARTMENT, MID-COLUMBIA CENTER FOR LIVING, NORTH CENTRAL PUBLIC HEALTH DISTRICT, ONE COMMUNITY HEALTH, PACIFIC SOURCE COMMUNITY SOLUTIONS.ALL ORGANIZATIONS LISTED IN PART V, SECTION B L.6A: B ARE UNDER THE UMBRELLA OF THE COLUMBIA GORGE REGIONAL COMMUNITY HEALTH AGENCY. MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 11: MCMC IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA IN THE FOURTH YEAR OF THE IMPLEMENTATION PLAN BY COORDINATING EFFORTS ACROSS HEALTHCARE AND SOCIAL SERVICES, PROVIDING SERVICES TO ASSIST WITH HEALTH INSURANCE ENROLLMENT AND RE-ENROLLMENT (HIRING ASSISTERS), COORDINATING SERVICES ACROSS THE SPECTRUM OF HEALTHCARE PROVIDERS AND SUPPORTING DEVELOPMENT AND HEALTHY GROWTH IN THE EARLY STAGES OF CHILDHOOD. WE ADDRESS THE IDENTIFIED NEEDS THROUGH A THREE-STEP REPETITIVE PROCESS: 1) IDENTIFY, 2) INTEGRATE RESPONSE AND 3) COMPILE ACTION ITEMS. FIVE CONDITIONS MUST BE MET FOR COLLECTIVE IMPACT SUCCESS: A COMMON AGENDA, SHARED MEASUREMENTS, MUTUALLY REINFORCING ACTIVITIES, CONTINUOUS COMMUNICATION AND BACKBONE ORGANIZATION (A DEDICATED TEAM WITH SPECIFIC SKILLS TO PROVIDE THE SUPPORT NECESSARY FOR A COHESIVE INITIATIVE.) IN THE FOURTH YEAR OF IMPLEMENTATION, THERE ARE NO IDENTIFIED AREAS IN WHICH NEEDS ARE NOT BEING ADDRESSED. MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 16J: MCMC CHARGES AND A LINK TO OUR FAP ARE AVAILABLE ON THE OREGON PRICEPOINT WEBSITE: HTTP://WWW.ORPRICEPOINT.ORG HOSTED BY THE OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 18E: REPORT ONLY TO THIRD PARTY COLLECTION AGENCY: ASSET RECOVERY MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 19E: IF THE THIRD PARTY COLLECTION AGENCY (ASSET RECOVERY) IDENTIFIES THAT AN INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE INDIVIDUAL IS REFERRED BACK TO THE HOSPITAL FOR FURTHER REVIEW. 10 1 - MCMC FAMILY MEDICINE 1620 E 12TH STREET THE DALLES OR 97058 HOSPITAL BASED CLINIC 2 - MCMC DERMATOLOGY 2690 MAY STREET HOOD RIVER OR 97031 NON-HOSPITAL BASED CLINIC 3 - COLUMBIA RIVER WOMEN'S CENTER 1810 E 19TH STREET STE 209 THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC 4 - GORGE UROLOGY 1805 E 19TH STREET THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC 5 - WATER'S EDGE INTERNAL MEDICINE 551 LONE PINE BLVD STE 201 THE DALLES OR 97058 HOSPITAL BASED CLINIC 6 - MCMC SURGICAL CLINIC 1810 E 19TH STREET STE 225 THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC 7 - COLUMBIA CREST FAMILY MEDICINE 1935 E 19TH STREET THE DALLES OR 97058 HOSPITAL BASED CLINIC 9 - MCMC PODIATRYUROLOGYORTHOPEDIC 33 NICHOLS PARKWAY HOOD RIVER OR 97031 NON-HOSPITAL BASED CLINIC 10 - COLUMBIA CREST DERMATOLOGY 1935 E 19TH STREET STE 110 THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC 11 - MCMC OCCUPATIONAL HEALTH 1815 EAST 19TH STREET SUITE 2 THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC PART I, LINE 3C: TRACK DIRECT LABOR AND OTHER COSTS IN EACH CATEGORY FOR ALL PATIENT SEGMENTS. IF ONLY REVENUE INFORMATION WAS AVAILABLE, A COST/CHARGE RATIO WAS APPLIED TO THE ESTIMATED COSTS. PART I, LINE 6A: COMMUNITY BENEFIT REPORT PREPARED BY MID-COLUMBIA MEDICAL CENTER PART I, LINE 7: COST-TO-CHARGE RATIO WAS UTILIZED; CCR WAS DERIVED FROM CALCULATION USED IN 2017 AUDITED FINANCIALS. 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 (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. BAD DEBT COST IS CALCULATED BY APPLYING THE HOSPITAL'S COST TO CHARGE RATIO. PART III, LINE 3: WE COMPARED AMOUNTS ALLOWED FOR CHARITY CARE TO TOTAL CHARGES TO CALCULATE AN ESTIMATED RATE. PART III, LINE 4: DESCRIPTION OF BAD DEBT POLICY CAN BE FOUND ON PAGE 9 OF THE 2017 FINAL AUDITED FINANCIAL STATEMENTS. 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 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.HEALTH OUTCOMES AND FACTORS 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, 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 26,437. 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 POPULATION TOTAL OF 51,861. MEDIAN INCOMES AND ETHNIC DEMOGRAPHICS VARY BY GEOGRAPHIC LOCATION. 2017 CENSUS DATA SHOWS MEDIAN INCOMES RANGE FROM $40,556 TO $49,633. WASCO COUNTY HAS THE LARGEST ETHNIC DIVERSITY WITH A DISTRIBUTION THAT IS 74% WHITE, 18% 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 13% OF THE POPULATION UNDER THE AGE OF 65 IS UNINSURED. 2017 DATA FROM THE OREGON HEALTH AUTHORITY CITES DECEMBER, 2017 MEDICAID PROGRAM ENROLLMENT IN WASCO COUNTY AT 9,953, AND 8,015 AT JULY 15, 2016, AN INCREASE OF 24%.IN ADDITION TO THE YEAR ROUND POPULATION, THE DALLES EXPERIENCES AN INFLUX OF 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 HEALTHCAREBOARD 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. 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 2016 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.HEALTH OUTCOMES AND FACTORS 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, 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.PLANETREE LECTURE SERIES *TAKING CARE OF YOUR EYES AS YOU AGE *LIVING WELL WITH HEART FAILURE *PLANNING FOR HEALTH: MEAL PLAN AND EXERCISE FOR ANY BODY *VERTIGO: WHAT IS IT AND WHAT HELPS *DEPRESSION - MORE THAN BLUE *PREVENTING PREMATURE SKIN AGING *CANCER SCREENING - CLEARING UP THE CONFUSION *SPRAINS, STRAINS AND OTHER ANKLE INJURIESPATIENT REHABILITATION SERVICES *PATIENT REHABILITATION SERVICES PROVIDED COMMUNITY EDUCATION AND ASSISTANCE IN THE DECISION-MAKING PROCESS FOR COMMUNITY MEMBERS CONSIDERING TOTAL JOINT REPLACEMENT *OVER 75 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. OVER 150 COMMUNITY MEMBERS ATTENDED THE SERIES *STEPS TO WELLNESS, TWO 90-MINUTE AND THREE 60-MINUTE TALKS GIVEN TO COMMUNITY MEMBERS AND PROVIDERS TO HELP THEM BETTER UNDERSTAND PAIN MANAGEMENT AND THE IMPORTANCE OF EDUCATION AND EXERCISE TO REACH THE GOAL OF LESSENING RELIANCE ON OPIATES. THE SERIES TARGETED MEDICAID AND MEDICARE RECIPIENTS AS WELL AS THE HISPANIC COMMUNITYPOVERTY AND UNINSURED *OUR PATIENT AND VISITOR 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 OTHER MEANINGFUL CONTRIBUTIONS IN THE YEAR 2017 *ANNUAL COMMUNITY DRUG-TAKE BACK: MID-COLUMBIA MEDICAL CENTER, IN PARTNERSHIP WITH LOCAL LAW ENFORCEMENT, YOUTH THINK AND TRI-COUNTY HAZARDOUS WASTE & RECYCLING, OFFERS FREE DROP-OFF OF HOUSEHOLD PRESCRIPTION, OVER THE COUNTER, VITAMIN/SUPPLEMENTS AND PET MEDICINES *MCMC PRODUCES A QUARTERLY HEALTH MAGAZINE (WELL AWARE) DISTRIBUTED TO OVER 17,000 HOUSEHOLDS THROUGHOUT THE SURROUNDING COMMUNITY, AT A COST OF APPROXIMATELY $26,000MCMC FACILITATES A VARIETY OF SUPPORT GROUPS ON A REGULAR BASIS, INCLUDING *MONTHLY STROKE CLUB *MONTHLY FAMILY SUPPORT CLASSES *MONTHLY PROSTATE CANCER SUPPORT GROUP *REACH FOR RECOVERY - BREAST CANCER SUPPORT GROUP *PARKINSON'S SUPPORT GROUP *PRE- OR BORDERLINE DIABETES CLASS *SURVIVORSHIP (POST-CANCER) SUPPORT GROUP *CAR SEAT EVALUATIONS, BIKE HELMET PROGRAMS AND TRAUMA NURSES TALK TOUGH ARE OFFERED ANNUALLY AT MAJOR MCMC AND OTHER COMMUNITY EVENTS *WITH A WIDELY DIVERSE ETHNIC POPULATION IN THE SERVICE AREA, INTERPRETATION SERVICES ARE IN HIGH DEMAND. IN 2014, MCMC IMPLEMENTED AUDIO / VIDEO REMOTE INTERPRETING TECHNOLOGY TO MEET LANGUAGE NEEDS IN THE HOSPITAL 24/7 TO ASSIST PATIENTS SEEKING CARE THROUGHOUT OUR ORGANIZATION AND TO ANY OTHER LOCAL HEALTH SERVICE PROVIDER, REGARDLESS OF AFFILIATION WITH MCMC. SPANISH SPEAKING STAFF REMAIN AVAILABLE FOR NON-MEDICAL INTERPRETATION SERVICES AT BOTH THE HOSPITAL AND OUTPATIENT CLINICS. MCMC IS WORKING TO CERTIFY QUALIFIED STAFF AS MEDICAL INTERPRETERS IN ORDER TO MEET SPECIFIC STATE REGULATIONS AND GUIDELINES *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, CHILD CARE 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 REGIONAL COMMUNITY ACTION COUNCIL BEGAN PRIORITIZING AN IMPLEMENTATION STRATEGY AROUND THESE TOPICS BEGINNING IN 2014; MCMC IS A PRIMARY PARTNER IN THOSE EFFORTS. 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 PACIFIC SOURCE COMMUNITY SOLUTIONS (PACIFIC SOURCE.) CGHC IS A NONPROFIT CORPORATION COMPRISED OF THE MEDICAL CENTER, WASCO AND HOOD RIVER COUNTIES, CENTRAL OREGON INDEPENDENT PRACTICE ASSOCIATION, INC., ONE COMMUNITY HEALTH, PACIFIC SOURCE, PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL AND AT-LARGE MEMBERS OF THE COMMUNITY. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 MID-COLUMBIA HEALTH FOUNDATION 1700 E 19TH STREET THE DALLES OR 97058 930854433 501(C)(3) 5000 OPERATIONAL SUPPORT PART I, LINE 2: AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR. X 0 0 X X X X X 1 1 0 0 0 1 0 0 0 PAUL CARDOSI MD SECRETARY 355284 0 25 0 0 0 13500 0 21196 0 390005 0 0 0 DIANNE STORBY INTERIM CEO 0 385232 0 0 0 0 0 13500 0 26284 0 425016 0 0 KEITH STELZER PHYSICIAN 634368 0 25 0 0 0 13500 0 14039 0 661932 0 0 0 GARY GINGRICH PHYSICIAN 398046 0 25 0 0 0 13500 0 14038 0 425609 0 0 0 MARC MCALLISTER PHYSICIAN 364584 0 25 0 0 0 13500 0 23346 0 401455 0 0 0 ANALENE PENTOPOULOS PHYSICIAN 279084 0 61320 0 0 0 13500 0 19546 0 373450 0 0 0 DENNIS KNOX CEO, EX-OFFICIO DIRECTOR 0 284025 0 0 0 0 0 12970 0 8779 0 305774 0 0 DUANE FRANCIS EX-OFFICIO DIRECTOR 0 0 0 160348 0 621825 0 0 0 0 0 782173 0 572665 DONALD ARBON FORMER - CFO 0 0 0 0 0 139619 0 0 0 0 0 139619 0 79924 EDWIN BODE FORMER - CFO 148800 0 0 0 0 0 0 0 0 0 148800 0 0 0 PART I, LINES 4A-B DUANE FRANCIS: - SEVERENCE COMPENSATION FROM HEALTH CARE FOR THE MID-COLUMBIA REGION TO BE PAID OUT IN 2017: $621,190 - NONQUALIFIED DEFERRED COMPENSATION FROM MID-COLUMBIA MEDICAL CENTER: $101,088. PAYMENT OF THE DEFERRED COMPENSATION WHICH HAS BEEN ACCRUING SINCE 2003 WILL BE MADE IN TEN ANNUAL INSTALLMENTS OF $160,348 BEGINNING 1/1/17. DONALD ARBON: - SEVERENCE COMPENSATION FROM HEALTH CARE FOR THE MID-COLUMBIA REGION TO BE PAID OUT IN 2017: $79,924 WILLIAM HAMILTON: - SEVERENCE COMPENSATION FROM MID-COLUMBIA MEDICAL CENTER TO BE PAID OUT IN 2017: $178,453 PART I, LINE 6 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. HEALTH CARE FOR THE MID-COLUMBIA REGION DIRECTLY CONTROLLING ENTITY OPERATING LOAN X 285613 0 0 0 MID-COLUMBIA HEALTH FOUNDATION RELATED TO MID-COLUMBIA HEALTH FOUNDATION BY COMMON PARENT ORGANIZATION OPERATING EXPENSES X 447427 0 0 0 DRY HOLLOW PROFESSIONAL CENTER INC WHOLLY OWNED SUBSIDIARY OF HEALTH CARE, THE CONTROLLING ENTITY OPERATING LOAN X 74254 0 0 0 807294 FORM 990, PART VI, SECTION A, LINE 6 HEALTH CARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. 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 THE BOARD ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. 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 MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 12,927,151. MANAGEMENT AND GENERAL EXPENSES 113,831. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,040,982. MISC OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 76,927. TOTAL EXPENSES 76,927. FORM 990, PART XI, LINE 9: INCREASE IN RESTRICTED NET ASSETS 210,395. INCOME FROM PASSTHROUGH ENTITIES FORM 990, PART XI, LINE 2C THE RESPONSIBILITY AND PROCESS FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. 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