NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK (EIN 93-0622075)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-12-21
- IRS object ID
- 201833559349300648
- Schema version
- 2017v2.2
- 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
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-12-21T14:03:16-08:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
| Disaster Relief | California Wildfires DR-4407 and IRS CA-2018-13 | DisasterReliefTxt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 800519547 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ACCOUNTANCY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 N BRAND BLVD STE 200 | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 912032361 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930622075 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Medical Foundation Tillamook | BusinessNameLine1Txt |
| Business Name Line2 | DBA Tillamook Regional Medical Center | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 5038424444 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Third St | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Smith Micah | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Signature | 2018-12-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | S Clement | PreparerPersonNm |
| PTIN | P01218012 | PTIN |
| Phone | 8185475701 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Butler | PrincipalOfficerNm |
| Gross Receipts | $84,242,613 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.adventisthealth.org/tillamook | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | Living God's love by inspiring health, wholeness and hope. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 566 | TotalEmployeeCnt |
| Total Volunteers | 66 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $146,136 | PYContributionsGrantsAmt |
| CY Contributions Grants | $135,807 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $77,460,170 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $83,609,460 | CYProgramServiceRevenueAmt |
| PY Investment Income | $499,590 | PYInvestmentIncomeAmt |
| CY Investment Income | $497,302 | CYInvestmentIncomeAmt |
| CY Other Revenue | -$74 | CYOtherRevenueAmt |
| PY Total Revenue | $78,105,896 | PYTotalRevenueAmt |
| CY Total Revenue | $84,242,495 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $15,000 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,090,653 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $41,279,912 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $2,307 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $35,901,022 | PYOtherExpensesAmt |
| CY Other Expenses | $35,359,852 | CYOtherExpensesAmt |
| PY Total Expenses | $72,991,675 | PYTotalExpensesAmt |
| CY Total Expenses | $76,654,764 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,114,221 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,587,731 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $56,005,159 | TotalAssetsBOYAmt |
| Total Assets EOY | $62,712,557 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,572,308 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,774,153 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $49,432,851 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $51,938,404 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Living God's love by inspiring health, wholeness and hope. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $69,740,624 | ExpenseAmt |
| Grant | $15,000 | GrantAmt |
| Revenue | $83,609,386 | RevenueAmt |
| Desc | Tillamook Regopma; Medical Center provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Tillamook County General Hospital the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Health's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at below costproviding health/wellness activities and community education programsNot only does Tillamook Regional Medical Center provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. Tillamook Regional Medical Center recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed value of providing care to these patients in 2017 was $3,872,320.Services in 2017 were provided to 81,965 patients. These services included:Babies delivered 151Surgeries performed 1,402Emergency room visits 10,700Medical clinics visits 359,458Tillamook Regional Medical Center recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission:Health FairBlood Pressure ClinicsFaith In ActionMulti ModularRespite careSeniors DayWomens Resource TrainingDoc Talks | Desc |
| Total Program Service Expenses | $69,740,624 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 73 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 566 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Micah Smith | PersonNm |
| Phone | 5038152263 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Third St | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Banks David | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,553 | $0 | ||||
| Cherry Robert | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $11,550 | $0 | ||||
| Davis Andrew | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $10,600 | $0 | ||||
| Freedman John | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,133 | $0 | ||||
| Gabriel Melody | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,203 | $0 | ||||
| Graham Ricardo | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $2,074 | $0 | ||||
| Heinrich Kerry | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $15,866 | $0 | ||||
| Innocent Larry | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $17,608 | $0 | ||||
| Pedersen James | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $2,101 | $0 | ||||
| Reiner Richard | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $19,819 | $0 | ||||
| Rippey Wesley | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $118,116 | $0 | ||||
| Salazar Velino | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,928 | $0 | ||||
| Reiner Scott | ||||||||||
| Dir/Chair | 0.00 | 50.00 | Yes (X) | $0 | $1,982,804 | $53,885 | Yes (X) | |||
| Wing Bill | ||||||||||
| Dir/VCh/AsstSec | 0.00 | 50.00 | Yes (X) | $0 | $1,460,244 | $52,693 | Yes (X) | |||
| Jobe Meredith | ||||||||||
| Secretary | 0.00 | 50.00 | $0 | $654,239 | $42,313 | Yes (X) | ||||
| Wagner Jack | ||||||||||
| Asst Secretary | 0.00 | 50.00 | $0 | $1,070,403 | $37,117 | Yes (X) | ||||
| Butler David | ||||||||||
| President/CEO | 50.00 | 0.00 | $0 | $453,166 | $53,858 | Yes (X) | ||||
| Larson Walter | ||||||||||
| Treas/Asst Sec | 50.00 | 0.00 | $0 | $85,681 | $2,144 | Yes (X) | ||||
| Saxon Kathleen | ||||||||||
| Pt Care Executive | 50.00 | 0.00 | $0 | $222,434 | $24,402 | Yes (X) | ||||
| Seufert Regina | ||||||||||
| VP Physician/Clinic Svcs | 50.00 | 0.00 | $0 | $229,303 | $25,093 | Yes (X) | ||||
| Newmyer Joyce | ||||||||||
| President PNR | 0.00 | 50.00 | $0 | $759,222 | $49,449 | Yes (X) | ||||
| Welch Donald | ||||||||||
| CFO PNR | 0.00 | 50.00 | $0 | $532,071 | $51,564 | Yes (X) | ||||
| Leach Judy | ||||||||||
| Strategy & Comm Exec PNR | 0.00 | 50.00 | $0 | $245,118 | $35,320 | Yes (X) | ||||
| Voshell Shane | ||||||||||
| VP HR PNR | 0.00 | 50.00 | $0 | $218,423 | $53,805 | Yes (X) | ||||
| Lafleur Brett | ||||||||||
| Physician | 40.00 | 0.00 | $640,572 | $0 | $47,693 | Yes (X) | ||||
| Kaba David | ||||||||||
| Physician | 40.00 | 0.00 | $547,144 | $0 | $51,316 | Yes (X) | ||||
| Naidoo Abendra | ||||||||||
| Physician | 40.00 | 0.00 | $497,073 | $0 | $38,846 | Yes (X) | ||||
| Mitchell Brandon | ||||||||||
| Physician | 40.00 | 0.00 | $490,252 | $0 | $48,431 | Yes (X) | ||||
| Thompson Albert | ||||||||||
| Physician | 40.00 | 0.00 | $402,982 | $0 | $27,384 | Yes (X) | ||||
| Rebok Douglas | ||||||||||
| Former Asst Sec | 0.00 | 0.00 | $0 | $120,028 | $6,244 | Yes (X) | ||||
| Wehtje Rodney | ||||||||||
| Former Asst Treas | 0.00 | 0.00 | $0 | $249,427 | $23,299 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,578,023 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,486,114 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $724,856 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 56 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Tillamook Emergency Services | |||||
| 1000 Third St | Tillamook | OR | 97141 | Physician Services | $2,180,199 |
| Bivens Medical Corporation | |||||
| 20105 Geisendorfer | Applegate | CA | 95703 | Physician Services | $1,651,793 |
| Staff Care Inc | |||||
| PO BOX 281923 | ATLANTA | GA | 30384 | Professional Fees | $718,944 |
| Rural Physicians Group | |||||
| 10624 S EASTERN AVE STE A-263 | HENDERSON | NV | 89052 | Physician Services | $693,000 |
| Opdahl Gregory Md Pc | |||||
| 4950 CLAM WAY WEST | Tillamook | OR | 97141 | Ophthomology | $661,165 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $135,807 | AllOtherContributionsAmt |
| Total Contributions | $135,807 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Dietary services | 722210 | $280,021 | $280,021 |
| Other revenue | 900099 | $391,474 | $391,474 |
| Patient service revenue | 900099 | $82,881,163 | $82,881,163 |
| Rental income | 531120 | $56,802 | $56,802 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $83,609,460 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $497,302 | TotalRevenueColumnAmt |
| Exclusion | $497,302 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $44 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $118 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$74 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$74 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,242,495 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $83,609,386 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $497,302 | 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 | $15,000 | TotalAmt |
| Program Services | $15,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,982,716 | TotalAmt |
| Program Services | $31,212,121 | ProgramServicesAmt |
| Management And General | $1,770,595 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,397,512 | TotalAmt |
| Program Services | $1,380,308 | ProgramServicesAmt |
| Management And General | $17,204 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,858,569 | TotalAmt |
| Program Services | $4,363,346 | ProgramServicesAmt |
| Management And General | $495,223 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,041,115 | TotalAmt |
| Program Services | $1,923,817 | ProgramServicesAmt |
| Management And General | $117,298 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,984 | TotalAmt |
| Management And General | $18,984 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$4,968 | TotalAmt |
| Management And General | -$4,968 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,032,546 | TotalAmt |
| Program Services | $7,783,540 | ProgramServicesAmt |
| Management And General | $249,006 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,769 | TotalAmt |
| Management And General | $46,769 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $909,883 | TotalAmt |
| Program Services | $839,940 | ProgramServicesAmt |
| Management And General | $69,282 | ManagementAndGeneralAmt |
| Fundraising | $661 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,274,198 | TotalAmt |
| Program Services | $4,248,870 | ProgramServicesAmt |
| Management And General | $25,328 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,880,584 | TotalAmt |
| Program Services | $1,872,644 | ProgramServicesAmt |
| Management And General | $7,940 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,474 | TotalAmt |
| Program Services | $101,995 | ProgramServicesAmt |
| Management And General | $184,833 | ManagementAndGeneralAmt |
| Fundraising | $1,646 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,904 | TotalAmt |
| Program Services | $221,318 | ProgramServicesAmt |
| Management And General | $159,586 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$2,611 | TotalAmt |
| Program Services | -$2,611 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,909,015 | TotalAmt |
| Program Services | $1,899,898 | ProgramServicesAmt |
| Management And General | $9,117 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,922 | TotalAmt |
| Program Services | $463,922 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased services | $9,390,777 | $5,752,360 | $3,638,417 |
| Patient care supplies | $7,491,311 | $7,491,311 | |
| Other expenses | $210,165 | $108,924 | $101,241 |
| Rental/lease equipment | $69,899 | $63,921 | $5,978 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,654,764 | TotalAmt |
| Program Services | $69,740,624 | ProgramServicesAmt |
| Management And General | $6,911,833 | ManagementAndGeneralAmt |
| Fundraising | $2,307 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,356 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,767,514 | BOYAmt |
| EOY | $25,667,188 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,589,806 | BOYAmt |
| EOY | $16,244,774 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,393,804 | BOYAmt |
| EOY | $1,717,030 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,782 | BOYAmt |
| EOY | $90,392 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,379,240 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $33,575,338 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,785,118 | BOYAmt |
| EOY | $11,803,902 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $442,741 | BOYAmt |
| EOY | $703,463 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,692,038 | BOYAmt |
| EOY | $6,485,808 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,005,159 | BOYAmt |
| EOY | $62,712,557 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,534,318 | BOYAmt |
| EOY | $5,595,548 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,037,990 | BOYAmt |
| EOY | $5,178,605 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,572,308 | BOYAmt |
| EOY | $10,774,153 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,391,520 | BOYAmt |
| EOY | $51,875,169 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,331 | BOYAmt |
| EOY | $63,235 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,432,851 | BOYAmt |
| EOY | $51,938,404 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,005,159 | BOYAmt |
| EOY | $62,712,557 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,587,731 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$5,082,178 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Church | Yes (X) | ChurchInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $6,058 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,058 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | The organization belongs to industry and professional associations - such as the Oregon Association of Hospitals and Health Systems - for which a portion of the membership dues is used for lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $41,331 | BeginningYearBalanceAmt |
| Contributions | $96,447 | ContributionsAmt |
| Grants Or Scholarships | $19,446 | GrantsOrScholarshipsAmt |
| Other Expenditures | $55,097 | OtherExpendituresAmt |
| End Year Balance | $63,235 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $697,451 | BeginningYearBalanceAmt |
| Contributions | $101,947 | ContributionsAmt |
| Other Expenditures | $758,067 | OtherExpendituresAmt |
| End Year Balance | $41,331 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,324,795 | BeginningYearBalanceAmt |
| Contributions | $159,334 | ContributionsAmt |
| Other Expenditures | $786,678 | OtherExpendituresAmt |
| End Year Balance | $697,451 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,830,000 | BeginningYearBalanceAmt |
| Contributions | $187,892 | ContributionsAmt |
| Other Expenditures | $693,097 | OtherExpendituresAmt |
| End Year Balance | $1,324,795 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,417,200 | BeginningYearBalanceAmt |
| Contributions | $150,062 | ContributionsAmt |
| Other Expenditures | $737,262 | OtherExpendituresAmt |
| End Year Balance | $1,830,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,056,181 | OtherCostOrOtherBasisAmt |
| Book Value | $1,056,181 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,674,697 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,290,772 | DepreciationAmt |
| Book Value | $8,383,925 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,991,936 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,247,792 | DepreciationAmt |
| Book Value | $744,144 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,656,426 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,036,774 | DepreciationAmt |
| Book Value | $1,619,652 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,803,902 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other assets | $26,078 |
| Other receivables | $337,598 |
| Receivables from 3rd party | $325,690 |
| Receivables from related organizations | $5,796,442 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,485,808 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Payables to rel orgs | $4,452,247 |
| Workers comp liability | $726,358 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,178,605 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4: Intended uses of the endowment fund. | FormAndLineReferenceDesc |
| Explanation | Board-designated, temporary and permanently restricted funds are for specified operating and capital projects. The funds are released as project costs are expended. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,244,504 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,244,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01620 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,244,504 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,244,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $557,027 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $78,869 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $478,158 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $121,410 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $121,410 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $70,890 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,450 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $67,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $749,327 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,319 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $667,008 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,993,831 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,319 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,911,512 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02490 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,889 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,889 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,246 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,246 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $625,644 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $625,344 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $681,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $681,479 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,279,330 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $724,357 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $27,903,440 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,618,692 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,284,748 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | Northwest Med Found Tillamook | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Third St | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | adventisthealth.org/Tillamook | WebsiteAddressTxt |
| State License | 14-1177 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Med Found Tillamook | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Sch H Part VI - Needs Assessment | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Sch H Part VI - Needs Assessment | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Sch H Part VI - Needs Assessment | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Sch H Part VI-Patient Education | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Sch H Part VI-Patient Education | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Sch H Part VI-Patient Education | 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 |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 5 - Account Input from Persons Who Represent the Community | The 2016 CHNA data collection process can be summarized as follows: 1. review of prior CHNA reporting efforts; 2. collection of most recently available demographic, socioeconomic and health indicator data.Data gathering was accomplished by using a widely-distributed community survey, engaging with community focus groups and conducting key stakeholder interviews.Community Survey: Tillamook Regional Medical Center conducted community organization surveys that asked about the health problems and health needs of the community. The community organization survey was emailed to organizations that collaborate with Tillamook Regional Medical Center in the form of an online survey. The survey addressed what community the organization serves, what is healthy in their community, what is not and what their community needs to be healthy. Twenty-five people responded to the online survey.Community Focus Groups: Twenty-eight people participated in three different focus groups. The focus groups were conducted at Tillamook Regional Medical Center and at Tillamook Seventh-day Adventist Church from March 21-22, 2016. Members of the focus groups included individuals or organizations that represented the medically underserved, low-income, and minority populations served by our hospital, as well as, community members at large. Focus group participants were snowball sampled through existing support groups and classes at Tillamook Regional Medical Center and leveraging of hospital administration's professional networks. Key Informant Interviews: Sixty-three people were surveyed in the form of ten key informant interviews. The groups were comprised of key leaders from an array of agencies including, local coalitions, not-for-profits, healthcare providers, and human service agencies. These were conducted by phone from February to April 2016. Key informants were identified through existing partnerships with community based organizations. Secondary data sources included publicly available state and nationally recognized data sources. Data on key health indicators, morbidity, mortality, and various social determinants of health were collected from the Census, Centers for Disease Control and Prevention, Community Commons, Nielsen, and various other state and federal databases. The quantitative data includes County specific data, and if available, data disaggregated to primary service area has been provided. When feasible, health metrics have been further compared to benchmarks, such as Healthy People 2020 objectives and State estimates. |
| Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment | None, TRMC is the only hospital in the County of Tillamook. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| AH Tillamook Medical Group | ||||
| 980 Third St | Tillamook | OR | 97141 | Outpatient Clinic |
| AH Tillamook Women and Family Clinic | ||||
| 1011 Third St | Tillamook | OR | 97141 | Outpatient Clinic |
| Manzanita Primary & Specialty Care | ||||
| 10445 Neahkahnie Creek Rd | Manzanita | OR | 97130 | Rural Health Clinic |
| Bayshore Family Medicine | ||||
| 38505 Brooten Rd Ste A | Pacific City | OR | 97135 | Rural Health Clinic |
| Bayshore Family Medicine | ||||
| 1105 SE Jetty Ave Ste C | Lincoln City | OR | 97367 | Rural Health Clinic |
| Adventist Health Banks | ||||
| 12350 NW Main Suite 112 | Banks | OR | 97106 | Rural Health Clinic |
| Adventist Health TillamookMedical Group-Estacada | ||||
| 103 SW Hwy 224 Suite B | Estacada | OR | 97023 | Rural Health Clinic |
| Adventist Health Tillamook Medical GroupHoodland | ||||
| 24461 E Welches Road | Welches | OR | 97067 | Rural Health Clinic |
| Tillamook Medical Plaza | ||||
| 1100 Third Street | Tillamook | OR | 97141 | Outpatient Clinic |
| Adventist Health - Vernonia | ||||
| 1005 Cougar Street | Vernonia | OR | 97064 | Rural Health Clinic |
| Specialty Clinic - Occupational Therapy | ||||
| 980 Third Street | Tillamook | OR | 97141 | Outpatient Clinic |
| Adventist Health Medical Group Surgery Services | ||||
| 980 Third Street Suite 100 | Tillamook | OR | 97141 | Outpatient Clinic |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7 - Explanation of Costing Methodology | The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows:(Total expenses - (Provision for bad debts + Other revenue + Interest income)) / Gross patient charges |
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide audited combined financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2. |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. |
| Part III, Line 4 - Bad Debt Expense | The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL*Medicare Cost Report Revenue 24,782,925Prior Year Settlements 108,637Cost Report Reimbursable Bad Debts 63,345Estimates and Accrual Variances 149,640Other 2,798,893Subtotal - Amount reported in Pt III, line 5 27,903,440Amounts included in Part I, lines f and g -Total Medicare Revenue 27,903,440*Note: The Medicare Cost Report Revenue includes the patient co-pay and deductible amounts, but not the bad-debt reimbursement. Adding the bad-debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest |
| Part VI, Line 2 - Needs Assessment | The hospital's 2016 CHNA, the 2017 Community Health Plan (CHP) Update/Annual Report, and the 2016 Implementation Strategy (adopted in May 2017), known as the 2017 Community Health Plan (Implementation Strategy) & 2016 Update/Annual Report, are posted on the hospital's website at https://www.adventisthealth.org/tillamook/about-us/community-benefit/. The CHNA, Implementation Strategy, and the CHPs are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/.Hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact.Committee/Board Participation includes: NW Regional Education Service District; Head Start Child and Family Development Program; Community Action Resource Enterprises (CARE, Inc.); Oregon Food Bank-Tillamook County Services; Food, Education, Agriculture, Solutions Together (FEAST); Tillamook Seventh-day Adventist Church; North County Food Bank-Nehalem; Tillamook Family Counseling Center; Northwest Oregon Regional Housing Center; and others. |
| Part VI, Line 3 - Patient Education of Eligibility for Assistance | The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the hospital's website at https://www.adventisthealth.org/tillamook/patient-resources/financial-services/financial-assistance/. These documents are available in multiple languages.At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. |
| Part VI, Line 4 - Community Information | Tillamook Regional Medical Centers service area is all of Tillamook County, which contains three geographic areas: Nehalem (North), Tillamook (Central), and Cloverdale (South). In addition to serving patients at the hospital, patients are also served at the five rural health clinics in our network. In the primary service area, the current year population is approximately 25,000. The largest age group is comprised of persons aged 45-64 years, with a median age of 49.2 compared to the U.S. median age of 37.9. The population is primarily composed of individuals who identify as White (89.8%) and the smallest group is composed of individuals who identify as Pacific Islander (0.3%) followed by African Americans (0.5%). In terms of ethnicity, 12.2% of the population is of Hispanic origin. English is the dominant language spoken in the service area. The percent of the population older than five years old that speaks English less than very well is low in the primary service area at 6% for Nehalem, 0.5% for Cloverdale, and 2.8% for Tillamook. The median income for all households is $43,037 which is lower than both the State of Oregon ($50,521) and the U.S. ($53,046). 29.2% of household in the area have an annual income of less than $25,000 compared to 24.1% for Oregon State and 23.4% for the U.S. |
| Part VI, Line 4 - Community Building Activities | The hospital is involved in numerous community building activities that promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. |
| Part VI, Line 5 - Promotion of Community Health | Our hospitals mission is, Living Gods love by inspiring health, wholeness and hope. Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the triple aim. The Triple Aim concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given todays state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthyeven though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population; 2) Factors that cause the present outcomes distribution; and 3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2) Improve care quality and patient safety, and 3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. |
| Part VI, Line 6 - Affilated Health Care System | The hospital is a member of Adventist Health, a health care system that provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. |
| Part VI, Line 7 - States Filing of Community Benefit Report | OR |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tillamook Cty Comm Health | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 489 | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash Grant | $10,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | Public health grant | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Butler David | |||||||||||
| President/CEO | $285,685 | $65,302 | $102,179 | $16,356 | $37,502 | $507,024 | $22,295 | ||||
| Jobe Meredith | |||||||||||
| Secretary | $395,752 | $98,614 | $159,873 | $16,356 | $25,957 | $696,552 | $60,017 | ||||
| Kaba David | |||||||||||
| Physician | $547,144 | $16,356 | $34,960 | $598,460 | |||||||
| Lafleur Brett | |||||||||||
| Physician | $640,572 | $10,956 | $36,737 | $688,265 | |||||||
| Leach Judy | |||||||||||
| Strategy & Comm Exec PNR | $214,584 | $30,534 | $12,712 | $22,608 | $280,438 | ||||||
| Mitchell Brandon | |||||||||||
| Physician | $490,252 | $16,356 | $32,075 | $538,683 | |||||||
| Naidoo Abendra | |||||||||||
| Physician | $497,073 | $16,356 | $22,490 | $535,919 | |||||||
| Newmyer Joyce | |||||||||||
| President PNR | $603,848 | $136,813 | $18,561 | $16,356 | $33,093 | $808,671 | |||||
| Rebok Douglas | |||||||||||
| Former Asst Sec | $120,028 | $6,244 | $126,272 | $120,028 | |||||||
| Reiner Scott | |||||||||||
| Dir/Chair | $1,184,750 | $324,119 | $473,935 | $16,356 | $37,529 | $2,036,689 | $406,467 | ||||
| Saxon Kathleen | |||||||||||
| Pt Care Executive | $172,121 | $27,602 | $22,711 | $11,503 | $12,899 | $246,836 | |||||
| Seufert Regina | |||||||||||
| VP Physician/Clinic Svcs | $161,786 | $25,811 | $41,706 | $12,197 | $12,896 | $254,396 | |||||
| Thompson Albert | |||||||||||
| Physician | $402,982 | $16,356 | $11,028 | $430,366 | |||||||
| Voshell Shane | |||||||||||
| VP HR PNR | $172,284 | $11,645 | $34,494 | $11,900 | $41,905 | $272,228 | |||||
| Wagner Jack | |||||||||||
| Asst Secretary | $755,988 | $221,735 | $92,680 | $11,160 | $25,957 | $1,107,520 | |||||
| Wehtje Rodney | |||||||||||
| Former Asst Treas | $158,863 | $90,564 | $213 | $23,086 | $272,726 | $79,970 | |||||
| Welch Donald | |||||||||||
| CFO PNR | $363,147 | $94,666 | $74,258 | $16,356 | $35,208 | $583,635 | |||||
| Wing Bill | |||||||||||
| Dir/VCh/AsstSec | $953,512 | $273,121 | $233,611 | $16,356 | $36,337 | $1,512,937 | $172,851 | ||||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Part VI, Line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors.Part VI, Line 7bThe sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | The completed Form 990 is shared with members of the corporation's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board prior to filing |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The hospital board of directors has established a Human Performance Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for executives with midpoints set at the median of the peer group and having a 50 percent spread (about 20% above and below midpoint) from minimum to maximum. The system CEO and Sr Vice Presidents (Executive Cabinet) have a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other executives have a maximum potential incentive of 25 percent of base salary. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The hospital does not make its governing documents publicly available beyond required filings of Articles of Incorporation and Bylaws with the Oregon Secretary of State and Oregon Department of Justice. The hospital does not make its conflict of interest policy publicly available. The hospital files monthly/quarterly summary financial reports with the Oregon Health Authority. |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Transfers to related organizations = -$5082178 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Adventist Health SystemWest | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 95661 | 953484589 | Support and manage system-wide activities | CA | 501(c)(3) | 1 | NA | false | |
| Adventist Health Clearlake Hospital Inc | |||||||||||
| Ave 18 at Hwy 53 | Clearlake | CA | 95422 | 680395149 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false | |
| Castle Medical Center | |||||||||||
| 640 Ulukahiki St | Kailua | HI | 96734 | 990107330 | Hospital | HI | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Feather River Hospital | |||||||||||
| 5974 Pentz Rd | Paradise | CA | 95969 | 941101228 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Glendale Adventist Medical Center | |||||||||||
| 1509 Wilson Ter | Glendale | CA | 91206 | 951816017 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Hanford Community Hospital | |||||||||||
| 450 Greenfield Ave | Hanford | CA | 93230 | 940535360 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Paradise Valley Hospital | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 95661 | 951816034 | Wind down after sale of hospital facilities | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Portland Adventist Medical Center | |||||||||||
| 10123 SE Market St | Portland | OR | 97216 | 930429015 | Hospital | OR | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| St Helena Hospital | |||||||||||
| 10 Woodland Rd | St Helena | CA | 94574 | 941279779 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| San Joaquin Community Hospital | |||||||||||
| 2615 Chester Ave | Bakersfield | CA | 93301 | 952294234 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Simi Valley Hospital & Health Care Svcs | |||||||||||
| 2975 N Sycamore Dr | Simi Valley | CA | 93065 | 956064971 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Sonora Community Hospital | |||||||||||
| 1000 Greenley Rd | Sonora | CA | 95370 | 941415069 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Ukiah Adventist Hospital | |||||||||||
| 275 Hospital Dr | Ukiah | CA | 95482 | 941639901 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Walla Walla General Hospital | |||||||||||
| 1025 S Second Ave | Walla Walla | WA | 99362 | 910617726 | Hospital | WA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| White Memorial Medical Center | |||||||||||
| 1720 Cesar E Chavez Ave | Los Angeles | CA | 90033 | 952282647 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Willits Hospital Inc | |||||||||||
| 1 Marcela Dr | Willits | CA | 95490 | 680108919 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Adventist Health Physicians Network | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 95661 | 680357690 | Medical Foundation | CA | 501(c)(3) | 11b, II | Adventist Health SystemWest | false | |
| Reedley Community Hospital | |||||||||||
| 372 W Cypress Ave | Reedley | CA | 93654 | 453220509 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
| Western Health Resources | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 95661 | 953867863 | Home care | CA | 501(c)(3) | 1 | false | N/A | |
| Lodi Memorial Hospital Association Inc | |||||||||||
| 975 S Fairmont Ave | Lodi | CA | 95240 | 941044474 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false | |
| Adventist Hlth Medical Ctr Tehachapi | |||||||||||
| 115 W E St | Tehachapi | CA | 93561 | 812240617 | Hospital | CA | 501(c)(3) | 1 | Adventist Health SystemWest | false | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Coast Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Douglas Blvd | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952037291 | EIN |
| Primary Activities | Wind down after sale of hospital | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C Corp | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | The reporting organization, a member of Adventist Health (System), is requesting abatement of late filing penalties due to extraordinary events occurring within the System caused by the Camp Fire in Butte County, California that erupted on November 8, 2018. On November 12, 2018, President Donald J Trump issued a Presidential Major Disaster Declaration. We request that the relief provided by the Internal Revenue Service in CA-2018-13 under IRC 7508A and Regulation 301.7508A-1 be applied to the reporting organization. The System experienced a catastrophic loss to the hospital in Paradise and multiple other buildings. Included in that loss was the building that housed critical information technology infrastructure. The morning following the start of the fire, the information technology area experienced System-wide loss of service over the following two weeks. The IT function had to make changes to accommodate the losses to infrastructure due to the fire. Tax software was not functional through November 30, 2018. During 2017 the System transitioned to an Enterprise Resource Planning cloud-based system and adopted a shared services model. This change resulted in the loss of personnel knowledgeable about the organizational structure, activities, and financial reporting of the entity. The ability to aggregate data consistent with prior years' reporting was challenging. More time was required to ensure reporting was in alignment with the tax format. Inquiry and reassignment of accounts was needed as we became aware of the constraints in the new ERP environment from within which we obtained the reporting data. Rebalancing of the income statement and net assets was critical and took extensive effort to complete. | ExplanationTxt |
Comments