2018-02-15T13:04:21-08:00 2017-03-31 990 2016-04-01 331065485 LEGACY SALMON CREEK HOSPITAL LEGA 5034155600 2211 NE 139TH STREET VANCOUVER WA 98686 SARAH K JENSEN INTERIM CFO 2018-02-15 2016 2021-01-29 14:40:06Z GEORGE J BROWN MD C/O 1919 NW LOVEJOY STREET PORTLAND OR 97209 326214540 false false X WWW.LEGACYHEALTH.ORG X 2002 WA Legacy Salmon Creek Hospital is Washington's most modern hospital and provides acute and critical care in Vancouver, WA. LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as 4 primary care physician practices and 13 specialty clinics. 16 14 0 545 689615 -108147 168422 342479 317074895 317529649 -602078 8329811 -835270 -1255221 315805969 324946718 9611 20858 0 179934345 189261626 0 0 97973739 97019360 277917695 286301844 37888274 38644874 371863933 411955608 39388598 37470586 332475335 374485022 Legacy Salmon Creek Hospital (LSCH), established in 2005, provides acute and critical care in Vancouver, with 165 licensed beds. LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and thirteen specialty clinics. LSCH provides a comprehensive range of inpatient, clinical and diagnostic services in numerous medical specialties and subspecialties. LSCH is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and achieve them Responsibility - Be good stewards of our resources, ensuring access to care for all Innovation - Be progressive in our thinking and actions Leadership - Serv false false 197459450 20858 300623994 LSCH was the State of Washington's first new hospital construction since 1979. The hospital opened in August 2005 with 165 licensed beds, all of which are single occupancy. LSCH provides a full array of hospital services, including surgery, diagnostics, inpatient and outpatient medical services, neonatal intensive care unit, pediatric, obstetrical, and emergency services. LSCH utilizes an electronic information system for medical records and physician order entry. Physicians are able to complete their entire patient records electronically and can remotely access patient records, including diagnostic images.In support of its mission, LSCH voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. During fiscal year 2017, LSCH provided financial assistance on approximately 11,770 patient accounts (of which 1,423 accounts received discounts totaling 100% of costs) and resulted in LSCH incurring roughly $6,481,380 in uncompensated costs associated with this program. In addition to charity care, LSCH provides services under various states' Medicaid programs for financially needy patients Medicare beneficiaries, and other government programs for which the cost of treating these patients exceeds the government payments received. During fiscal year 2017, LSCH incurred approximately $26,184,980, $19,062,720 and $624,490 in uncompensated costs attributable to Medicaid, Medicare and other government programs respectively. LSCH also provides a variety of other community benefit activities such as medical education, donations to other charitable entities, research, and other health improvement services, which totaled roughly $1,346,990 during fiscal year 2017.LSCH is part of Legacy, which collectively provided over $46 million, $199 million, $113 million, and $2 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2017. In addition, Legacy provided over $23 million in other community benefit activities during fiscal year 2017. 29033433 16905655 LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and thirteen specialty clinics in southwest Washington. From it's opening in 2005, LSCH has used an electronic health information system for medical records and physician order entry. 226492883 true true false true false false false false false true true true false false true false false true false false false false false false false false true true true false true false false false false false false false false false false false true false false false false true true false false false true 0 0 false 0 false true true false false false false false false 0 false false false false false false false false false false X 16 14 false false false false true true true true true false false true true true true true true true true true true X X SARAH K JENSEN 5034155600 1919 NW LOVEJOY STREET PORTLAND OR 97209 BISHOP DAVID BRAUER-RIEKE BOARD DIRECTOR 3.00 0.00 X 0 0 0 JONATHAN HILL MD BOARD DIRECTOR 3.00 40.00 X 0 595264 34436 SHERYL MANNING BOARD DIRECTOR 4.00 0.00 X 0 37250 0 DAVID RAMUS BOARD DIRECTOR 3.00 0.00 X 0 17750 0 ROBERT L CORNIE BOARD DIRECTOR 4.00 0.00 X 0 32899 0 DIANE PINNEY BOARD DIRECTOR 4.00 0.00 X 0 21000 0 JEFFREY D FULLMAN MD Chairman 4.00 1.00 X X 0 79293 0 CORLISS A MCKEEVER BOARD DIRECTOR 3.00 0.00 X 0 10750 0 LESLIE ROOT MD BOARD DIRECTOR 1.00 4.00 X 0 20000 0 RONALD S KING VICE CHAIR 4.00 0.00 X X 0 49943 0 JEFFREY BARBER BOARD DIRECTOR 3.00 0.00 X 0 21117 0 CHARLES WILHOITE BOARD DIRECTOR 3.00 0.00 X 0 16551 0 STEPHEN G NEWBERRY MD BOARD DIRECTOR 3.00 0.00 X 0 31994 0 JAMES WALKER BOARD DIRECTOR 3.00 0.00 X 0 20437 0 JOHN W WINTER JR BOARD DIRECTOR 4.00 0.00 X 0 38500 0 GEORGE J BROWN MD President & CEO 0.00 40.00 X X 0 1601886 609328 NANCY R LOCKE BOARD DIRECTOR 3.00 0.00 X 0 5250 0 PATRICK REITEN BOARD DIRECTOR 3.00 0.00 X 0 21000 0 GAYLE GOSCHIE BOARD DIRECTOR 3.00 0.00 X 0 5750 0 RT REV MICHAEL J HANLEY BOARD MEMBER 3.00 0.00 X 0 0 0 ROBERT E DEWITT SR VP & SEC 0.00 40.00 X X 0 505269 42836 LINDA S HOFF CFO & TREASURER 0.00 40.00 X X 0 731073 279593 BRYCE HELGERSON HOSPITAL PRESIDENT 40.00 0.00 X 502602 0 67362 CAROL A BRADLEY SR VP 0.00 40.00 X 0 469741 69793 TRENT S GREEN SR VP 0.00 40.00 X 0 546117 239727 SONJA O STEVES SR VP 0.00 40.00 X 0 441126 102382 EVERETT NEWCOMB III MD SR VP 0.00 40.00 X 0 1125666 337067 MAUREEN A BRADLEY SR VP 0.00 40.00 X 0 339181 51366 TERESA L HANDY VP 40.00 0.00 X 291590 0 61044 JOHN J KENAGY SR VP 0.00 40.00 X 0 522921 218485 LEWIS L LOW MD SR. VP 0.00 40.00 X 0 639273 85365 FRED H COLEMAN MD OB-GYN 40.00 0.00 X 392787 0 33115 WON LEE MD ONCOLOGIST 40.00 0.00 X 434620 0 30067 AKASHDEEP S SANDHU MD PHYSICIAN 40.00 0.00 X 411585 0 50552 CHRISTOPHER A STAMATAKOS MD PHYSICIAN 40.00 0.00 X 392412 0 48355 TIMOTHY J RODDY MD PHYSICIAN 40.00 0.00 X 390146 0 68021 JONATHAN E AVERY FORMER CAO 0.00 40.00 X 0 527475 84440 SARAH K JENSEN FORMER VP 0.00 40.00 X 0 274182 35118 2815742 8748658 2548452 293 true true false LEASE CRUTCHER LEWIS LLC 550 SW 12TH AVE PORTLAND OR 97205 CONSTRUCTION 3017900 JAMES E JOHN CONSTRUCTION CO 1701 SE COLUMBIA RIVER DR VANCOUVER WA 98661 CONSTRUCTION 1014565 COLUMBIA ANESTHESIA GROUP PO BOX 5157 VANCOUVER WA 98668 MEDICAL SERVICES 564000 THE VANCOUVER CLINIC INC PO BOX 4195 PORTLAND OR 97208 MEDICAL SERVICES 915339 ZIMMER GUNSUL FRASCA ARCHITECTS LLP 1223 SW WASHINGTON ST 200 PORTLAND OR 97205 CONTRUCTION 533517 30 342479 48640 342479 CHARITY CARE -20853978 -20853978 CONTRACTUAL ALLOWANCE -553890858 -553890858 CONVENIENCE OF MEMBERS 1887532 1887532 PATIENT PROGRAM REV 889697338 889697338 RETAIL PHARMACY 689615 689615 317529649 8331982 8331982 0 0 10430 1265651 -1255221 -1255221 -1255221 2171 -2171 -2171 -2171 0 0 0 0 324946718 314952502 689615 8962122 20858 20858 0 0 0 922597 837695 84902 0 153491824 116378305 37113519 4837095 3652258 1184837 19150474 13761661 5388813 10859636 8221200 2638436 0 323785 50159 273626 0 60000 60000 0 0 3718927 3718927 0 44925380 42266995 2658385 0 0 616478 496992 119486 297120 192493 104627 0 214022 172540 41482 0 0 12937849 10419833 2518016 2875217 2501581 373636 CONTRACT SERVICES 15357961 11700967 3656994 PROVIDER TAX 7106817 7106817 TAXES WA B&O, USE & SALES 4391558 3540384 851174 ADMINISTRATIVE SERVICES 1815254 1815254 2378992 1453218 925774 286301844 226492883 59808961 0 670379 814031 0 0 42606395 41904009 0 0 0 1924102 1956229 534430 928221 343977985 171508191 176288166 172469794 0 146637629 190680487 0 0 3202832 3202837 371863933 411955608 22576713 24934954 16811885 12535632 39388598 37470586 X 332475335 374485022 332475335 374485022 371863933 411955608 X 38644874 3364813 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false X 83300 188776 83300 188776 247040405 1525779063 247123705 1525967839 1000000 1000000 250000 250000 false 2000000 2000000 2000000 2000000 8000000 12000000 355538 317778 364027 272076 1309419 500000 500000 500000 500000 2000000 3000000 1454517 413224 35113 650434 1252420 933265 688272 -7216 159805 1454516 853457 392141 11649 323982 933265 519310 583398 4468 253719 853457 275304 392109 267 148370 519310 0.60000 0.40000 false true true 10278013 10278013 244384441 106678183 137706258 30958 21099 9859 88348219 64808909 23539310 936354 936354 172469794 190680487 NONCURRENT PENSION LIABILITY 11867424 NONCURRENT WORKERS' COMP LIABILITY 668208 12535632 322902000 322902000 2044718 2044718 324946718 284469000 284469000 1832844 1832844 286301844 Part V, Line 4: Intended uses of the endowment fund. Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Salmon Creek Hospital Foundation (SCHF) maintains all charitable gifts including endowment funds for the benefit of LSCH and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator. Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S MEDICAL STAFF INCOME $313548 FOUNDATION DONATION $293839 OTHER EXPENSE $-4063 GAIN / LOSS OF SALE OF ASSETS $-2171 PROGRAM SERVICE REVENUE $1395049 IN KIND DONATION $48640 ROUNDING $-124 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S MEDICAL STAFF EXPENSE $259250 FOUNDATION DONATION $185353 OTHER EXPENSE $-4063 GAIN / LOSS OF SALE OF ASSETS $-2171 PROGRAM SERVICE REVENUE $1395049 ROUNDING $-574 true true X true X 300.000000000 true X true true true false true true 6481380 6481380 0.02260 66210733 40025757 26184976 0.09150 3827279 3202786 624493 0.00220 76519392 43228543 33290849 0.11630 94727 94727 0.00030 691479 691479 0.00240 560782 560782 0.00200 1346988 1346988 0.00470 77866380 43228543 34637837 0.12100 false 46578905 52019874 -5440969 X true true 1 1 LEGACY SALMON CREEK HOSPITAL 2211 NE 139TH STREET VANCOUVER WA 98686 www.legacyhealth.org HAC.FS.00000208 X X X LEGACY SALMON CREEK HOSPITAL 1 false false true X X X X X X X X X 14 true true true true X www.legacyhealth.org true 14 true www.legacyhealth.org false false true X 300.0000 400.0000 X X X X X true true X X X true X www.legacyhealth.org X www.legacyhealth.org X www.legacyhealth.org X X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community In 2014, Legacy Salmon Creek Medical Center participated with the 14 other hospitals, four public health departments and two Coordinated Care Organizations in the metro four county area regional Healthy Columbia Willamette Collaborative Community Health Needs Assessment (CHNA) which was used as a base for the Legacy Salmon Creek FY 15 Community Health Needs Assessment. The results of Legacy's community needs assessment can be found at www.legacyhealth.org.The 2014 Community Needs Assessment is conducted based on the Healthy Columbia Willamette Collaborative (HCWC) Community Health Needs Assessment (CHNA). The HCWC CHNA is regional and developed to improve efficiency and effectiveness and also to help meet the requirements of the ACA and Public Health Accreditation. The regional CHNA obtained information from the community through a variety of venuessurveys and interviews with public health, tribal, regional, state or local health or other departments as well as medically underserved, low income and minority populations and those with chronic disease needs; a review of community engagement/needs assessment projects; and community listening sessions with uninsured and/or low-income community members from diverse culturally-identified and geographic communities. The following organizations were surveyed or interviewed.Adelante Mujeres Adult Mental Health and Substance Abuse Advisory Council Allies for a Healthier Oregon Ant Farm Calvary Church Central City Concern Clackamas County Public Health Advisory Committee Clackamas Service Center Coalition of Community Health Clinics Elders in Action Commission El Programa Hispano FamilyCare Community Advisory Council Free Clinic of SW Washington Hacienda CDC Health Share of Oregon Community Advisory Council Highland Church & Highland Access, Reentry and Recovery Program Immigrant and Refugee Community Organization The Intertwine Alliance Latino Network Liberation Street Church Lifeline Connections LifeWorks Northwest Multnomah County Health Equity Initiative Native American Youth Association National Alliance on Mental Illness (Clackamas) OHSU Richmond Clinic Health Literacy Committee Oregon Community Health Worker Association Oregon Health Equity Alliance Outside In Oregon Foundation for Reproductive Health Oregon Public Health Institute Project Access NOW Q Center Urban League of Portland Veterans Affairs Hospital Washington County Mental Health and Addictions Advisory Council Washington County Public Health Advisory Council Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment In addition to Legacy Salmon Creek Medical Center, the HCWC comprised of 14 other hospitals in the metro area and are as follows : Adventist Medical Center, Kaiser Permanente Sunnyside Medical Center, Kaiser Permanente Westside Medical Center, Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center, Legacy Mount Hood Medical Center, Oregon Health & Science University, Peace Health Southwest Medical Center, Providence Milwaukie Medical Center, Providence Portland Medical Center, Providence St. Vincent Medical Center, Providence Willamette Falls Medical Center and Tuality Health Care/Tuality Community Hospital. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Legacy Salmon Creek did not address needs identified in the Community Needs Assessment for the reasons explained in the following, by need. These are included in the Community Needs Assessment and Implementation Strategies Plan.NEED: Early Childhood: limited financial and labor resources prevent addressing as need.NEED: HIV/AIDS: limited financial and labor resources prevent addressing as need.NEED: Autism: limited financial and labor resources prevent addressing as need. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense LSCH uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, LSCH must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The estimated amount of bad debt expenses attributable to charity care policy was calculated using the demographic profile of household income and average household size in the zip code areas around the hospital. 57% of Households in the LSCH service area would qualify for financial assistance with incomes under 400% of the Federal Poverty Guidelines using this methodology. Part III, Line 4 - Bad Debt Expense The footnote that describes the Legacy bad debt expense can be found on page 11 of the attached audited financial statements. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $100,418,550 and $119,481,260 respectively. This results in a total Medicare shortfall of $19,062,710.Costing Methodology (Part III, Line 8).Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Legacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues. Part VI - Needs Assessment The described CHNA provides the primary source for assessing needs. Senior leadership, in conjunction with the Board of Directors, continually assesses the needs of the communities it serves through a compilation of primary and secondary market research (qualitative and quantitative), medical staff input, reviewing national trends and practices, working with local foundations and funders regarding their assessments, and working with local community-based partners to understand their needs. The goal is to understand the needs and develop programs specific to the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of these assessments is the development of both long-term and fiscal year plans that are supported by a yearly budget that is proposed by staff and approved by the Board of Directors. Community Benefit and Community Relations staff as well as Legacy representatives on nonprofit and community based boards serving communities at risk also provide ongoing informal feedback regarding needs. These are then aligned to the community health needs identified in the formal CHNA. During 2014, Legacy Health conducted a community needs assessment. The results of the assessment can be found at www.LegacyHealth.org.The region served by Legacy Salmon Creek Hospital (LSCH), along with most of Washington, is experiencing significant challenges in population growth, economic development, education and health care. Recognizing that social and economic determinants impact health, LSCH has been and will remain committed to addressing these issues to improve the health of all residents in the community, including equity among ethnically diverse populations. Part VI - Patient Education of Eligibility for Assistance LSCH employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, LSCH's financial assistance program, and public assistance programs, such as Medicaid. The criteria for financial assistance under LSCH's program is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for medically necessary services provided. Specifically, the LSCH Financial Assistance Program provides an uninsured discount of 35% to patients who have resided within LSCH's primary service area for a period of six months, are uninsured for hospital care, and have a household income of less than $100,000 annually. Further discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level or roughly $97,000 for a family of four in Portland, Oregon. For patients whose household income is at or below 300% of the federal poverty level, a full subsidy is available. In addition to the household income criteria, the patients' qualified assets (e.g. 25% of household assets), and other catastrophic or economic circumstances are considered in determining eligibility. In addition to financial counselors and social workers, LSCH makes every effort to communicate its Financial Assistance Program to patients. This includes signage in main admitting areas of each hospital and brochures explaining financial assistance in all patient care areas, as well as in appropriate languages. Financial counselors are available to assist patients in understanding and applying for available resources, including the LSCH Financial Assistance Program. LSCH's website also has information about the availability of financial assistance. LSCH offers financial assistance customer service Monday through Friday, as well as the availability of voice mail so patients can leave confidential, detailed messages during non-business hours. Finally all of Legacy's billing statements include information regarding the availability of financial assistance. If LSCH requires the use of a collection agency, those agencies are required to provide a telephone number that patients can call to request financial assistance.In 2010, Legacy Health established the Health Literacy initiative. Nearly all Legacy employees are touch points to patients and families and health literacy is involved in every touch point. What is health literacy? The Institute of Medicine defines health literacy as the capacity to obtain, understand, and process basic health information and services needed to make appropriate health decisions. In short, health literacy is the ability to understand and act on health information. Nearly half of the U.S. adult population has a low level of health literacy. Patients with low health literacy are less likely to comply with treatment, less likely to seek preventive care and twice as likely to be hospitalized. Quality, safety and cost are all affected by a patient's inability to understand medical instructions and to explain their symptoms/issuesLegacy's employees are learning and practicing new way of communicating with patients using health literacy tools such as universal precautions, plain language and teach back methods. Annual education is provided to all billing and admitting staff so they can be kept informed of and speak with knowledge about current financial assistance policies and options. LSCH provides copies of the latest policies in main admitting areas, as well as through newsletters and other publications. Since 2008, the four county metro area health delivery systems (encompassing all hospitals in the area) and safety net clinics have partnered to establish a seamless, coordinated program to provide care for the low income uninsured, Project Access. This program enables low income uninsured patients to receive continuity of care in earlier stages of acuity due to the collaboration among 2800 providers and all health systems. Part VI - Community Information LSCH opened in 2005 in north Clark County between the cities of Vancouver to the south and Battle Ground and Ridgefield to the north in an unincorporated area known as Salmon Creek and Hazel Dell. The primary service area is defined as the five mile radius, but due to the hospital's location in an unincorporated area and since there are only two hospitals in the county, the county is the commonly used primary service area composition. This definition extends from the Columbia River on the south, north to La Center, west to Vancouver Lake and east to Camas. The primary service area extends from the Columbia River on the south, to La Center in the north, Vancouver Lake in the west and Camas in the east. The primary service area includes the cities of Vancouver, Battle Ground, Ridgefield and Camas. Vancouver and Camas are industrial, commercial and residential communities while and Battle Ground and Ridgefield are primarily residential. Zip codes for the primary service area include: 98601, 98603, 98604, 98606-07, 98616, 98622, 98629, 98642, 98660-68, 98671, 98674-75, and 98682-87. In 2013, the population of the LSCH primary service area was 449,457 with an estimated five percent growth projected between 2013 and 2018. Clark County represents 20.6 percent of the four-county population of 2.2 million residents. The LSCH primary service area was 80.5 percent non-Hispanic white, 8.5 percent Hispanic, 1.9 percent African American, 4.8 percent Asian and Pacific Islander, 3.5 percent bi-racial, .1 percent other race and .7 percent Native American. The Clark County population is growing in diversity, although continuing to be nine percent less diverse than the state. The Hispanic population in Clark County nearly doubled between 2000 and 2010.From 2008-2012, Clark County had a median household income (MHI) of $58,764 with 12.0 percent of the population living below poverty. In contrast, Washington County in Oregon had a MHI at $64,375 with 10.9 percent below poverty, followed by Clackamas County at $63,951 with 9.7 percent below poverty and Multnomah at $51,582 with 17.1 percent below poverty. In Clark County, non-Hispanic white median household income was at $60,621, while Black/African Americans had the lowest MHI of $35,395 followed by American Indian/Alaska Native at $41,477 and Hispanic/Latino at $41,815. In contrast, Asians MHI was $66,181. The 2012-2013 overall high school graduation rate was 79.8 percent in Clark County. County-level race and ethnicity data is not available, but a sampling of school districts within service areas reveals distinct differences. Two main school districts in the LSCH service area show the non-Hispanic white cohort to have a graduation rate higher than African Americans, Hispanics, Asian Pacific Islanders and Native Americans.The Dignity Health and Truven Health Community Needs Index (CNI) is accepted as the national standard in identifying communities with health disparities and comparing relative need. Legacy Salmon Creeks community health focus is the highest Community Needs Index zip codes in its service area which include: 98660-West Vancouver, 98661-Downtown Vancouver, 98663-Rosemere East Vancouver and 98665-Hazel Dell.Peace Health SW Washington Medical Center is the only other hospital that serves the LSCH primary service area. In 2013, Kaiser Permanente entered into a 7 year contract with LSCH. According to the contract, LSCH became the new partner hospital for Kaisers 100,000 members in Clark County. The service area includes a Medically Underserved Areas (MUA) in central Vancouver. There is also one non-public sector Federally Qualified Health Center (FQHC) operated by SeaMar and one long-standing volunteer-based safety net Free Clinic in Vancouver. The Clark County Health Department does not operate primary care services directly.A local non-profit, Project Access Clark County, links uninsured low income individuals to no-cost healthcare services. All of the health systems in the metro area are very involved with this program. Legacy Health provides cash donations as well as clinical services.The Affordable Care Act is significantly increasing the insured rate in Oregon. With a June 2013 Oregon uninsured rate of 14 percent, by June 2014 the rate had decreased to 5.1 percenta 63 percent decrease (from 550,000 to 202,000 people). Most of the newly enrolled are now in the Oregon Health Plan which increased 360,000 people--59 percent.In FY 17, LSCH provided $6.5 million in charity care; total unreimbursed costs of care for people in need amounted to $33.3 million. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Non-cash donations of resources include clinical and non-clinical services and items, e.g., screenings and support services, internships, information and referral services and health fairs. Legacys warehouse located in NW Portland, is open to nonprofit organizations to obtain surplus equipment and furniture. In addition, conference room space is made available to local nonprofits for Board and community meetings.Clinical staff is involved with local communities through many child safety programs. In 1986, nurses in member hospital Legacy Emanuels Level I Trauma Center developed the Trauma Nurses Talk Tough (TNTT) program. The American Hospital Association awarded the TNTT program its NOVA Award. In addition, Legacy staff members conduct free education sessions to show parents how to properly install car seats. Last year, Legacy staff fit and sold more than 8,000 bicycle helmets to children at a nominal or no fee based on need. Legacy staff members also provide new parents with training to reduce the incidences of shaken baby syndrome and a Safety Store sells child protection devices for the home at nominal charge. Part VI - Affilated Health Care System Roles and Promotion LSCH is a subsidiary of Legacy Health (Legacy). Legacy is an integrated health system based in Portland, Oregon and primarily operates six acute care hospitals and related services (e.g., physician practices, hospice, preferred provider network) in the four county metro area of Portland and SW Washington. The Legacy Board is comprised of community and business leaders as well as representatives of the medical staff. The LSCH medical staff is open, with physicians submitting credentialing information reviewed according to LSCH policies and standards. In 1998, the Legacy Health Board approved a $10 million Community Health Fund from operating revenue to address major community health issues. About $500,000 annually has been granted to community-based projects addressing racial and ethnic inequities and root causes. These dollars are in addition to the systems generous charitable contributions. The Community Health Fund has provided 50 grants since 1998 totaling over $8.1 million. An example is the Legacy Salmon Creek service area three year $170,200 grant providing summer academic help for 500 homeless and low income students as well as practical experience for new teachers to better understand what life is like for kids who head home to a crowded shelter or even a tent. The goal is two-foldto increase academic success for students facing significant socio and economic challenges and to develop more effective teaching during the academic year when the teachers are in their own classrooms. In 2010, Legacy Health established the Health Literacy initiative. Communication with patients such that patients both understand AND can act on the information required of and provided to them is critical to their health outcomes. Patients must use information to navigate the health system (complete insurance and government forms, sign consents, schedule appointments), manage diseases and acquire preventive screenings. Providers (defined as all staff interacting with or developing materials used by patients) are responsible for ensuring that patients can act on the information provided. Funded by the Community Health Fund in 2012, Legacy hosted the first Oregon and SW Washington Health Literacy Conference. 360 people from 69 organizations attended. Since 2012, the Health Literacy Conference has been organized every year with more than 500 health professionals attending each year from 80 organizations. Legacy Health is now the recognized leader in moving health literacy forward both in the health delivery system and broader community.Recognizing that education, employment and income inequities exist for communities of diversity, and that health professions are lacking in diversity, Legacy established the Youth Employment in Summer program in 1999. Fifteen African American, Hispanic and Native American youth receive paid summer employment in departments where they work with health professionals and college scholarships between $3,000 and $6,000 annually. Students remain in the program as long as they remain in school and pursued health careers. Some students remain in the program as long as seven yearsgraduating with imaging tech degrees, bachelor degrees in nursing, etc. The vast majority of the students are the first in their families to go to college. In addition to the Community Health Fund, Legacy provided cash donations to local health and human service, education, economic development and civic organizations. Donations focus on organizations with year-round relationships through programs and board representationspecifically focused organizations addressing disparities. A few examples include Columbia River Mental Health Services, The Childrens Center, Free Clinic of SW Washington and NAMI Clark County. In addition, Legacy Health lab services provided more in-kind services to the local safety net clinic in Battle Ground, Washington. true MEDICAL TEAMS INTERNATIONAL 14150 SW MILTON CT TIGARD OR 97224 930878944 501(c)(3) 0 20858 COST SUPPLIES FOR DISASTER ASSISTANCE 1 0 Grantmaker's Description of How Grants are Used Legacy reviews all organizations prior to donating cash or supplies to ensure their 501(c)(3) status. Legacy regularly donates supplies to Medical Teams International for disaster relief. Several Legacy medical staff members, volunteer for Medical Teams International. X true true false true false true true true true false true true AKASHDEEP S SANDHU MD PHYSICIAN 223692 176832 11061 21759 28793 462137 BRYCE HELGERSON HOSPITAL PRESIDENT 391820 108998 1784 55976 11386 569964 CAROL A BRADLEY SR VP 363719 100645 5377 40287 29506 539534 CHRISTOPHER A STAMATAKOS MD PHYSICIAN 197692 198211 -3491 22805 25550 440767 EVERETT NEWCOMB III MD SR VP 642989 211041 271636 303743 33324 1462733 262521 FRED H COLEMAN MD OB-GYN 356554 19250 16983 24130 8985 425902 GEORGE J BROWN MD President & CEO 1060375 402174 139337 554496 54832 2211214 116315 JOHN J KENAGY SR VP 397730 109931 15260 186928 31557 741406 JONATHAN E AVERY FORMER CAO 407220 107557 12698 56178 28262 611915 JONATHAN HILL MD BOARD DIRECTOR 495206 75794 24264 10880 23556 629700 LEWIS L LOW MD SR. VP 495694 137164 6415 54233 31132 724638 LINDA S HOFF CFO & TREASURER 552657 181393 -2977 253924 25669 1010666 MAUREEN A BRADLEY SR VP 255549 82897 735 27589 23777 390547 ROBERT E DEWITT SR VP & SEC 390062 107326 7881 28622 14214 548105 SARAH K JENSEN FORMER VP 244462 30601 -881 22689 12429 309300 SONJA O STEVES SR VP 346728 95943 -1545 80138 22244 543508 TERESA L HANDY VP 237309 46799 7482 35154 25890 352634 TIMOTHY J RODDY MD PHYSICIAN 197692 196861 -4407 38511 29510 458167 TRENT S GREEN SR VP 431959 118187 -4029 206962 32765 785844 WON LEE MD ONCOLOGIST 432697 667 1256 19286 10781 464687 Part I, Line 1a: Relevant information in regards to selections on 1a. Legacy does periodically reimburse for some travel of companions. During 2016, some travel expenses for companions of Legacy Board Directors and executives were reimbursed. These transactions follow Legacys reimbursement policy requiring documentation and approval of the expenses, prior to reimbursement. These payments are taxable to the individuals and are reported on a W-2 for employees or a 1099 for Board Directors. Part I, Line 5b: Explanation of organization compensation based on revenues of related organization Physicians employed by Legacy affiliates are paid a bonus contingent upon their revenue generated during the year measured by industry standard relative value units (RVU). Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or Legacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets. Part I, Line 8: Amounts reported on 990 VII pursuant to initial contract exemption described in Regs Legacy enters into initial employment agreements with executives that qualify under the initial contract exception. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee relies on comparable market data and all decisions are documented. Part III, Additional Information Sch J, Part 1, Question 3 Regarding Compensation PracticesDirectors for Legacy started receiving compensation for their services in August 2014. They also receive expense reimbursements related to their duties. Any expense reimbursements to board members are reviewed by the Director of Tax for determining 1099 tax reporting. In addition to the Board of Directors compensation, during 2016, Dr. Hill received compensation related to his duties as Medical Director while Dr. Fullman received compensation for medical services provided to Legacy Meridian Park Hospital. There was no other reportable compensation received by any board member during 2016.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market.The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for executive positions. The Committee oversees the system's governance procedures with respect to intermediate sanctions legislation and the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Sch J, Part II, Column Breakdown Of W-2 Or Misc-1099:Column B(i) - Base compensation consists of regular base pay including employee elected deferrals for retirement plans (403(b) and 457(b) plans).Column B(ii) - The incentive compensation program for Legacy is based on predetermined criteria and reviewed and approved by the Board. Bonuses are paid to key employees for interim duties outside their primary responsibilities (e.g. Acting in Capacity).Column B(iii) - Other compensation consists of deferred compensation amounts paid to executives during the current year and were reported on prior form 990 returns.These amounts include arrangements that contain elements of a substantial risk of forfeiture conditioned on continued employment, vesting and/or a noncompete provision upon termination of employment. Distributions from 457(b) plans, reported to the employee on a 1099-R, are also included as other compensation. In addition, imputed income for insurance, cell phone and other benefits is included in other compensation as well as any severance related payments.Column C - Deferred compensation includes the value of defined benefit plans, contributions to defined contribution plans, amounts deferred under the 457(f) plan including earnings, earnings in the 457(b) plan, and the value of the pension restoration plan. Earnings on the 457(f) and 457(b) include gains and losses on the underlying investments.The defined contribution plan is available to all employees as they become qualified to participate. The pension restoration plan provides executive pension benefits in excess of IRS mandated limits on eligible compensation to key executives. The benefits are unfunded and subject to forfeiture. Executive pension benefits are intended to make the executive's retirement benefit, as a proportion of their final average salary, comparable to all other employees, and are treated as income when paid.The Legacy Health Board approved the goals and long-term objectives for the Executive Long Term Incentive Plan effective April 1, 2014 for 3 years ending on March 31, 2017. The plan was discretionary and could be terminated at any time. The purpose of the Plan was to attract and retain highly qualified senior executives, to focus management performance and reward participants for contributing to the accomplishments of Legacys long-term objectives. The longterm strategic goals included the development of a health plan partnership strategy; partner withother local healthcare providers to open a center for behavioral health; expanded use of information technology and data analytics to improve patient care; and executing an urgent care strategy to improve access to care and reduce emergency visits. Targets for operating margins and clinical quality were required over the three year period and all goals were measured at March 31, 2017. The Plan was funded and paid out in May 2017 after approval from the Legacy Health Compensation committee and the Legacy Health Board. A portion of the pay out was reported as deferred compensation on the FY2016 990. The balance amount will be reported asdeferred compensation for FY2017.Column D - Nontaxable benefits include company paid health and welfare and long term care and disability benefits under group plans.Column F - Current year compensation reported as deferred in prior years. X 1 48640 false false false Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Legacy Health is the sole member of Legacy Salmon Creek Hospital. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors includes the following members: (a) The Bishop of the Oregon Synod of the Evangelical Lutheran Church inAmerica (the "Oregon Synod") or the Bishop's designee, who shall serve ex officio;(b) The Bishop of the Episcopal Diocese of Oregon (the "Episcopal Diocese")or the Bishop's designee, who shall serve ex officio;(c) One (1) person appointed by election of the Oregon Synod Council;(d) One (1) person appointed by election of the Convention of the EpiscopalDiocese. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The appointed persons by the Oregon Synod Council and the Convention of the Episcopal Diocese may not be removed from the Board without written consent of their respective organizations. Form 990, Part VI, Line 11b: Form 990 Review Process The Legacy Board received a copy of the 990 return prior to filing. At the direction of the entire Board, the Board Compensation Committee reviewed the compensation disclosures and the Board Audit Committee received a memorandum with draft 990 returns for Legacy and Legacy Emanuel Hospital & Health Center highlighting key areas and requesting feedback. Questions from the Board Audit Committee are answered and changes made where appropriate. Any significant differences in disclosure from the draft 990 to the final 990 return for other affiliated entities, including Legacy Salmon Creek Hospital are provided to the Board Audit Committee. Depending on the deadline for the 990 return filing and the Board Audit Committee meeting this discussion may take place following the filing of the return. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The following is a summary of Legacy's policy and procedures for conflict of interest disclosure, monitoring and resolution.All Legacy employees and non-employees in leadership positions (e.g., Board members, Foundation Trustees, Medical Directors) are required to disclose potential conflicts of interest as the conflict arises. All employees are required to disclose any conflict of interest per the Standard of Conduct policy. Certain groups have annual formal disclosure requirements, Executives and non-employees in leadership positions complete the Conflict Disclosure Statement from the Standards of Conduct policy annually. Officers, Directors, Trustees, Key and Highly Compensated employees are also required to complete a questionnaire covering business relationships, business transactions with interested parties, loans and grants. Conflict Disclosure Statements and questionnaires are returned to Legacy Corporate Compliance or Tax Departments for review of the disclosure. If a conflict is disclosed, or identified through any other means, Legacy Corporate Compliance ensures that management mitigates the risk (e.g., discontinues relationship with vendor, segregates responsibilities, recuses Board member from voting in area of conflict) and that the conflict and mitigation steps are reported to the appropriate level (e.g., Compliance Committee, Audit Committee of the Board). Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The following describes the compensation practices of Legacy and its affiliates.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee oversees the system's governance procedures with respect to the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Legacy Health's audited and interim consolidated financial statements are publicly available on the Electronic Municipal Market Access(EMMA) (www.emma.msrb.org) and DAC Bond (www.dacbond.com) websites. Legacy's audited consolidated financial statements include consolidating schedules which highlights LSCH's financial results.When changes are made to the LSCH Articles or Bylaws, LSCH discloses and attaches copies to the IRS Form 990, which are publicly available by request or on various public websites such as Guidestar(www.guidestar.org). Other governing documents are not available to the public. Other Changes In Net Assets Or Fund Balances - Other Increases CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY = $3495382 Other Changes In Net Assets Or Fund Balances - Other Decreases GIFT SHOP OPERATIONS FUND = -$82049 Other Changes In Net Assets Or Fund Balances - Other Decreases IN KIND DONATION = -$48640 Other Changes In Net Assets Or Fund Balances - Other Increases OTHER = $124 Other Changes In Net Assets Or Fund Balances - Other Decreases ROUNDING = -$4 Form 990, Part IV, question 12 Legacy has an audit of its consolidated financial statement which includes consolidating schedules highlighting LSCH's financial results. Form 990, Part VI, question 2 Legacy Health System CPC, LLC (CPC) is a common pay agent for Legacy and its affiliates. The CPC files all required federal employment tax returns for Legacy and its affiliates. The number of employees reported on Form W-3 for LSCH is 2,397. Form 990, Part X LSCH participates in the Legacy investment pooled funds which include professionally managed equity and fixed income securities in both separately managed portfolios and commingled investment accounts. Investment returns are prorated according to each affiliate's share of the pool. Form 990, Schedule J Schedule J Reporting of Officers and Senior Management on Legacy Affilate Returns. The Legacy Officers, Senior Vice Presidents and other key employees may have responsibilities for the operations of the entire health system, including the affiliated entities. Their compensation is paid from and reported on the Legacy return(EIN 23-7426300). The compensation is reported again for informational purposes on related affiliated entity returns including, Legacy Emanuel Hospital & Health Center, Legacy Good Samaritan Hospital and Medical Center, Legacy Meridian Park Hospital, Legacy Mount Hood Medical Center, Legacy Salmon Creek Hospital, Silverton Health, Legacy Visiting Nurse Association, and Legacy Adventist Venture. 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