MID-COLUMBIA MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MID-COLUMBIA MEDICAL CENTER (EIN 93-0386936)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201643199349312059
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T19:09:17-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930418710 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAP LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5885 MEADOWS ROAD NO 200 | AddressLine1Txt |
| City | LAKE OSWEGO | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97035 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930386936 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MID- | BusinessNameControlTxt |
| Phone | 5412961111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DON ARBON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5412961111 | PhoneNum |
| Signature | 2016-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK E EKLUND CPA | PreparerPersonNm |
| PTIN | P00156145 | PTIN |
| Phone | 5036974118 | PhoneNum |
| Preparation | 2016-11-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | DIANNE STORBY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1580 | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $135,309,564 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCMC.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1135 | TotalEmployeeCnt |
| Total Volunteers | 175 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $134,997 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,667,108 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $106,979,510 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $109,629,027 | CYProgramServiceRevenueAmt |
| PY Investment Income | $758,068 | PYInvestmentIncomeAmt |
| CY Investment Income | $792,259 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,563,614 | PYOtherRevenueAmt |
| CY Other Revenue | $7,954,520 | CYOtherRevenueAmt |
| PY Total Revenue | $112,436,189 | PYTotalRevenueAmt |
| CY Total Revenue | $125,042,914 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $19,653 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $126,356 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $69,859,429 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,724,425 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $540,548 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $39,965,841 | PYOtherExpensesAmt |
| CY Other Expenses | $42,983,982 | CYOtherExpensesAmt |
| PY Total Expenses | $109,844,923 | PYTotalExpensesAmt |
| CY Total Expenses | $116,834,763 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,591,266 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,208,151 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $60,416,427 | TotalAssetsBOYAmt |
| Total Assets EOY | $72,692,438 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,484,710 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,561,646 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $33,931,717 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,130,792 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $103,636,114 | ExpenseAmt |
| Grant | $126,356 | GrantAmt |
| Revenue | $117,538,410 | RevenueAmt |
| Desc | ACUTE HOSPITAL CARE: INPATIENT DAYS 7,222, INPATIENT REHAB DAYS 1,392, OUTPATIENT OBSERVATION DAYS 1,158, LABORATORY TESTS 251,953, IMAGING TESTS 32,619, HOME HEALTH EPISODES 1,889, EMERGENCY VISITS 16,638, ENDOSCOPY VISITS 1,331, MEDICAL ONCOLOGY 9,051, OUTPATIENT SURGERIES 1,494, RADIATION ONCOLOGY OUTPATIENT PROCEDURES 7,602, TOTAL HOSPITAL OUTPATIENT VISITS 121,019 AND TOTAL OUTPATIENT CLINIC VISITS 110,366.SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS. | Desc |
| Total Program Service Expenses | $103,636,114 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 143 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1135 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5412961111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH STREET | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| WALLACE WOLF JR DVM | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAN BOLDT | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| PAUL CARDOSI MD | |||||||||
| SECRETARY | 50.00 | Yes (X) | $269,670 | $0 | $28,494 | Yes (X) | |||
| ROB CARNAHAN | |||||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| CARINA SCHMIDT | |||||||||
| VICE-CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PHIL BRADY | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK ENGER | |||||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||||
| DUANE FRANCIS | |||||||||
| PRESIDENT & CEO | 50.00 | Yes (X) | $0 | $672,827 | $151,052 | Yes (X) | |||
| DONALD ARBON | |||||||||
| CFO & VP FINANCE | 50.00 | $0 | $225,588 | $29,395 | Yes (X) | ||||
| REGINA ROSE | |||||||||
| VP CHIEF NURSING OFFICER | 50.00 | $183,741 | $0 | $32,053 | Yes (X) | ||||
| WILLIAM HAMILTON MD | |||||||||
| VP MEDICAL AFFAIRS | 50.00 | $388,355 | $0 | $35,867 | Yes (X) | ||||
| DIANNE STORBY | |||||||||
| EXEC VP OF OPERATIONS | 1.00 | $0 | $289,641 | $32,197 | Yes (X) | 50.00 | |||
| ERICK LARSON | |||||||||
| VP CHIEF INFORMATION OFFIC | 1.00 | $0 | $175,863 | $26,142 | Yes (X) | 50.00 | |||
| XINYU STEVE FU | |||||||||
| PHYSICIAN | 50.00 | $701,636 | $0 | $29,794 | Yes (X) | ||||
| JOHN SCHWARTZ | |||||||||
| PHYSICIAN | 50.00 | $551,521 | $0 | $24,188 | Yes (X) | ||||
| KEITH STELZER | |||||||||
| PHYSICIAN | 50.00 | $592,827 | $0 | $27,294 | Yes (X) | ||||
| GARY GINGRICH | |||||||||
| PHYSICIAN | 50.00 | $456,387 | $0 | $26,688 | Yes (X) | ||||
| MARK CULLEN | |||||||||
| PHYSICIAN | 50.00 | $683,383 | $0 | $22,178 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,827,520 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,363,919 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $465,342 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 107 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| OREGON HEALTH & SCIENCE UNIVERSITY | |||||
| 318 SW SAM JACKSON PARK RD | PORTLAND | OR | 97239 | PRO FEES FOR SPECIALTY CLINIC PROVIDERS | $2,719,150 |
| CORESOURCE INC | |||||
| PO BOX 83301 | LANCASTER | PA | 17608 | HEALTH INSURANCE CLAIMS PROCESSOR | $657,991 |
| CELILO SURGICAL LLC | |||||
| 1810 E 19TH ST 225 | THE DALLES | OR | 97058 | PRO FEES, ER CALL | $587,250 |
| QUEST DIAGNOSTICS | |||||
| 3 GIRALDA FARMS | MADISON | NJ | 07940 | LAB SERVICES | $404,101 |
| PATRICK GRIMSLEY DO PC | |||||
| 1700 E 19TH ST | THE DALLES | OR | 97058 | ER PHYSICIAN & MEDICAL DIRECTOR | $392,489 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 21 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $25,759 | GovernmentGrantsAmt |
| All Other Contributions | $6,641,349 | AllOtherContributionsAmt |
| Total Contributions | $6,667,108 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $109,629,027 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $109,629,027 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $109,629,027 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $258,734 | TotalRevenueColumnAmt |
| Exclusion | $258,734 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $110,150 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $110,150 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,150 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $110,150 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,800,175 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,241,117 | SecuritiesAmt |
| Other | $25,533 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $559,058 | SecuritiesAmt |
| Other | -$25,533 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $533,525 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$25,533 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $559,058 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| FITNESS & SPA CENTER | 713940 | $1,153,683 | $1,153,683 |
| CAFETERIA | 722100 | $784,316 | $784,316 |
| DAYCARE | 624410 | $435,178 | $435,178 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,471,193 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,471,193 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,844,370 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $125,042,914 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $117,558,014 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $817,792 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,356 | TotalAmt |
| Program Services | $126,356 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,827,521 | TotalAmt |
| Program Services | $3,255,424 | ProgramServicesAmt |
| Management And General | $572,097 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,002,847 | TotalAmt |
| Program Services | $50,661,810 | ProgramServicesAmt |
| Management And General | $4,049,157 | ManagementAndGeneralAmt |
| Fundraising | $291,880 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,502,429 | TotalAmt |
| Program Services | $2,283,481 | ProgramServicesAmt |
| Management And General | $205,639 | ManagementAndGeneralAmt |
| Fundraising | $13,309 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,382,040 | TotalAmt |
| Program Services | $6,942,963 | ProgramServicesAmt |
| Management And General | $1,438,713 | ManagementAndGeneralAmt |
| Fundraising | $364 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,009,588 | TotalAmt |
| Program Services | $3,670,952 | ProgramServicesAmt |
| Management And General | $317,801 | ManagementAndGeneralAmt |
| Fundraising | $20,835 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500,000 | TotalAmt |
| Management And General | $1,500,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,900 | TotalAmt |
| Management And General | $220,900 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,477 | TotalAmt |
| Management And General | $117,277 | ManagementAndGeneralAmt |
| Fundraising | $3,200 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,411 | TotalAmt |
| Fundraising | $10,411 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,579,785 | TotalAmt |
| Program Services | $5,623,241 | ProgramServicesAmt |
| Management And General | $811,688 | ManagementAndGeneralAmt |
| Fundraising | $144,856 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,807 | TotalAmt |
| Program Services | $329,602 | ProgramServicesAmt |
| Management And General | $10,415 | ManagementAndGeneralAmt |
| Fundraising | $10,790 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $489,303 | TotalAmt |
| Program Services | $436,537 | ProgramServicesAmt |
| Management And General | $52,766 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,968 | TotalAmt |
| Fundraising | $8,968 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,095,988 | TotalAmt |
| Program Services | $3,435,174 | ProgramServicesAmt |
| Management And General | $638,083 | ManagementAndGeneralAmt |
| Fundraising | $22,731 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,117 | TotalAmt |
| Program Services | $307,629 | ProgramServicesAmt |
| Management And General | $38,747 | ManagementAndGeneralAmt |
| Fundraising | $2,741 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,937 | TotalAmt |
| Program Services | $157,937 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,366,303 | TotalAmt |
| Program Services | $3,052,348 | ProgramServicesAmt |
| Management And General | $313,696 | ManagementAndGeneralAmt |
| Fundraising | $259 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,184,068 | TotalAmt |
| Program Services | $1,115,571 | ProgramServicesAmt |
| Management And General | $68,167 | ManagementAndGeneralAmt |
| Fundraising | $330 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $21,855,394 | $21,590,286 | $256,958 | $8,150 |
| PURCHASED SERVICES | $1,390,590 | $1,390,590 | ||
| OTHER | $1,303,934 | $646,803 | $655,407 | $1,724 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,834,763 | TotalAmt |
| Program Services | $103,636,114 | ProgramServicesAmt |
| Management And General | $12,658,101 | ManagementAndGeneralAmt |
| Fundraising | $540,548 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,717,667 | BOYAmt |
| EOY | $3,784,610 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,779,877 | BOYAmt |
| EOY | $1,342,125 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,625,322 | BOYAmt |
| EOY | $16,680,945 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,764 | BOYAmt |
| EOY | $82,486 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,319 | BOYAmt |
| EOY | $246,790 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,740,821 | BOYAmt |
| EOY | $1,711,258 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,379,614 | BOYAmt |
| EOY | $3,431,933 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $71,121,127 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $44,634,449 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,916,294 | BOYAmt |
| EOY | $26,486,678 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,831,870 | BOYAmt |
| EOY | $13,085,735 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,186 | BOYAmt |
| EOY | $500,687 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,871 | BOYAmt |
| EOY | $944,606 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,609,784 | BOYAmt |
| EOY | $1,610,560 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,679,038 | BOYAmt |
| EOY | $2,784,025 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,416,427 | BOYAmt |
| EOY | $72,692,438 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,270,701 | BOYAmt |
| EOY | $11,072,961 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,792 | BOYAmt |
| EOY | $107,982 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,730,640 | BOYAmt |
| EOY | $16,222,719 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,475,577 | BOYAmt |
| EOY | $4,157,984 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,484,710 | BOYAmt |
| EOY | $31,561,646 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,769,280 | BOYAmt |
| EOY | $34,955,919 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,162,437 | BOYAmt |
| EOY | $6,174,873 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,931,717 | BOYAmt |
| EOY | $41,130,792 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,416,427 | BOYAmt |
| EOY | $72,692,438 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,208,151 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$845,485 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | -$50,014 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | -$113,577 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,389,999 | BeginningYearBalanceAmt |
| Contributions | $11,182 | ContributionsAmt |
| Investment Earnings Or Losses | $51,092 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $23,019 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,429,254 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,345,021 | BeginningYearBalanceAmt |
| Contributions | $8,511 | ContributionsAmt |
| Investment Earnings Or Losses | $48,321 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $11,854 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,389,999 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,310,867 | BeginningYearBalanceAmt |
| Contributions | $12,621 | ContributionsAmt |
| Investment Earnings Or Losses | $27,470 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,937 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,345,021 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,287,095 | BeginningYearBalanceAmt |
| Contributions | $6,237 | ContributionsAmt |
| Investment Earnings Or Losses | $23,245 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,710 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,310,867 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,266,891 | BeginningYearBalanceAmt |
| Contributions | $9,137 | ContributionsAmt |
| Investment Earnings Or Losses | $17,965 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $6,898 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,287,095 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.71690 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.26460 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.01850 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $562,933 | OtherCostOrOtherBasisAmt |
| Book Value | $562,933 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,973,185 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,581,068 | DepreciationAmt |
| Book Value | $4,392,117 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,230,429 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,875,538 | DepreciationAmt |
| Book Value | $2,354,891 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,873,630 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,177,843 | DepreciationAmt |
| Book Value | $18,695,787 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $480,950 | OtherCostOrOtherBasisAmt |
| Book Value | $480,950 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,486,678 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| IBNR RESERVE | $930,552 |
| SETTLEMENT RESERVES | $1,890,731 |
| DEFERRED COMPENSATION | $1,336,701 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,157,984 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $120,483,616 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $707,569 | OtherRevenueAmt |
| Revenue Not Reported | $707,569 | RevenueNotReportedAmt |
| Revenue Subtotal | $119,776,047 | RevenueSubtotalAmt |
| Other Revenues Not Included | $5,266,867 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,266,867 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $125,042,914 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $116,951,801 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $707,569 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $707,569 | ExpensesNotReportedAmt |
| Expenses Subtotal | $116,244,232 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $590,531 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $590,531 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $116,834,763 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE FOUNDATION'S ENDOWMENT FUND IS A QUASI-ENDOWMENT THAT FUNDS THE MID-COLUMBIA HEALTH FOUNDATION OPERATING EXPENSES - ENDING BALANCE $1,024,711. THE REMAINING ENDOWMENT FUNDS SUPPORT SEVERAL SCHOLARSHIPS AND OTHER FUNDS EXPLAINED BELOW: TEMPORARY AND PERMANENTLY RESTRICTED FUNDS: - EVELYN KASER SCHOLARSHIP FUND: TO INSURE THAT INDIVIDUALS WHO DESIRE TO BECOME REGISTERED NURSES HAVE THIS EDUCATIONAL OPPORTUNITY DESPITE FINANCIAL CONCERNS. - LORNA & JOSEPH HALLIDAY FAMILY NURSING SCHOLARSHIP FUND: TO ASSIST INDIVIDUALS ASPIRING TO BECOME REGISTERED NURSES WHO GREW UP IN THE MID-COLUMBIA REGION. - MCMC BOARD OF TRUSTEES MEDICAL PROFESSIONALS SCHOLARSHIP: TO HELP DEFRAY SOME COLLEGE EXPENSES FOR GRADUATING SENIORS FROM THE DALLES HIGH SCHOOL. - PERMANENT SCHOLARSHIP FUND: EARNS INTEREST THAT IS ANNUALLY TRANSFERRED TO THE MID-COLUMBIA MEDICAL CENTER SCHOLARSHIP FUND. |
| PART X, LINE 2: | INCOME TAX POSITIONS THAT MEET A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE MEDICAL CENTER'S BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE MEDICAL CENTER'S STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | IN-KIND SUPPORT FROM OREGON HEALTH & SCIENCE UNIVERSITY 707,569. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTIONS FROM MID-COLUMBIA HEALTH FOUNDATION 50,014. CONTRIBUTIONS FROM OREGON HEALTH & SCIENCE UNIVERSITY 5,087,002. INCOME FROM PASSTHROUGH ENTITIES 129,851. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | IN-KIND SUPPORT FROM OREGON HEALTH & SCIENCE UNIVERSITY 707,569. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES FOR MID-COLUMBIA HEALTH FOUNDATION 540,531. GRANT TO MID-COLUMBIA HEALTH FOUNDATION 50,000. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3236 | PersonsServedCnt |
| Total Community Benefit Expns | $2,820,844 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,820,844 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02410 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,810,245 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,963,156 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,847,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05860 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3236 | PersonsServedCnt |
| Total Community Benefit Expns | $22,631,089 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,963,156 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,667,933 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 29000 | PersonsServedCnt |
| Total Community Benefit Expns | $422,997 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $422,997 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $462,398 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $462,398 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,994 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,994 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,191 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,540 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,012,666 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,012,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 29000 | PersonsServedCnt |
| Total Community Benefit Expns | $1,923,246 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,540 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,918,706 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01640 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 32236 | PersonsServedCnt |
| Total Community Benefit Expns | $24,554,335 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,967,696 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,586,639 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09910 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,287 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,287 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,867 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $44,867 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $186,477 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $186,477 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $498 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $498 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $260,129 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $260,129 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $821,877 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $82,188 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $31,504,737 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $29,334,251 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,170,486 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH STREET | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MCMC.NET | WebsiteAddressTxt |
| State License | 14-0500 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.MCMC.NET | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.MCMC.NET | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.MCMC.NET | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.MCMC.NET | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.MCMC.NET | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Other Actions | Yes (X) | OtherActionsInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B | FACILITY REPORTING GROUP A |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 5: | IN PREPARING THE CHNA IN 2014, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WE SERVE, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF/EXPERTISE IN PUBLIC HEALTH BY CREATING A COLLABORATIVE, CROSS-ORGANIZATIONAL, CROSS-COUNTY FORUM, THE MEMBERS OF WHICH AGREE ON THE NEEDS WITHIN OUR REGION AND COMMUNITIES AND AGREE TO SUPPORT OUR ABILITY TO ADDRESS THOSE NEEDS TOGETHER. WE ELECTED TO ALSO INCLUDE THE SOCIAL SERVICE AGENCIES AND NON-PROFITS THAT SERVE OUR AREAS' MOST VULNERABLE POPULATIONS.THE PERSONS CONSULTED INCLUDE: BARB SEATTER M.S., CATHERINE WHALEN, DIRECTOR OF COMMUNITY INITIATIVES MID-COLUMBIA MEDICAL CENTER (MCMC), COCO YACKLEY, ELLEN LARSEN RN, ERIN QUINN MSN, FNP, JULIE REYNOLDS PHD, MAIJA YASUI, MARK THOMAS CHAPLAIN, MEGAN MCANINCH MSC, TERI THALHOFER RN, BSN, DIRECTOR NORTH CENTRAL PUBLIC HEALTH DISTRICT. |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 6A: | THE HOSPITAL'S (MCMC) CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: KLICKITAT VALLEY HEALTH, PROVIDENCE HOOD RIVER HOSPITAL AND SKYLINE HOSPITAL. |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 6B: | THE HOSPITAL'S (MCMC) CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITIES: COLUMBIA GORGE HEALTH COUNCIL, HOOD RIVER COUNTY HEALTH DEPARTMENT, KLICKITAT VALLEY HEALTH DEPARTMENT, MID-COLUMBIA CENTER FOR LIVING, NORTH CENTRAL PUBLIC HEALTH DISTRICT, ONE COMMUNITY HEALTH, PACIFIC SOURCE COMMUNITY SOLUTIONS. |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 11: | MCMC IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA IN THE FIRST YEAR OF THE IMPLEMENTATION PLAN BY COORDINATING EFFORTS ACROSS HEALTHCARE AND SOCIAL SERVICES, PROVIDING SERVICES TO ASSIST WITH HEALTH INSURANCE ENROLLMENT AND RE-ENROLLMENT (HIRING ASSISTERS), COORDINATING SERVICES ACROSS THE SPECTRUM OF HEALTHCARE PROVIDERS AND SUPPORTING DEVELOPMENT AND HEALTHY GROWTH IN THE EARLY STAGES OF CHILDHOOD. WE ADDRESS THE IDENTIFIED NEEDS THROUGH A THREE-STEP REPETITIVE PROCESS: 1) IDENTIFY, 2) INTEGRATE RESPONSE AND 3) COMPILE ACTION ITEMS. FIVE CONDITIONS MUST BE MET FOR COLLECTIVE IMPACT SUCCESS: A COMMON AGENDA, SHARED MEASUREMENTS, MUTUALLY REINFORCING ACTIVITIES, CONTINUOUS COMMUNICATION AND BACKBONE ORGANIZATION (A DEDICATED TEAM WITH SPECIFIC SKILLS TO PROVIDE THE SUPPORT NECESSARY FOR A COHESIVE INITIATIVE.) IN THE FIRST YEAR OF IMPLEMENTATION, THERE ARE NO IDENTIFIED AREAS IN WHICH NEEDS ARE NOT BEING ADDRESSED. |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 16I: | MCMC CHARGES AND A LINK TO OUR FAP ARE AVAILABLE ON THE OREGON PRICEPOINT WEBSITE: HTTP://WWW.ORPRICEPOINT.ORG HOSTED BY THE OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 18D: | REPORT ONLY TO THIRD PARTY COLLECTION AGENCY: ASSET RECOVERY |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 19D: | IF THE THIRD PARTY COLLECTION AGENCY (ASSET RECOVERY) IDENTIFIES THAT AN INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE INDIVIDUAL IS REFERRED BACK TO THE HOSPITAL FOR FURTHER REVIEW. |
| MID-COLUMBIA MEDICAL CENTER PART V, SECTION B, LINE 22D: | THE HOSPITAL ANNUALLY TAKES ACCOUNTS PAID BY COMMERCIAL INSURANCE, MEDICARE AND MEDICAID ADVANTAGE PLANS FOR THE PRIOR 12-MONTH PERIOD TO DETERMINE THE WRITE-OFF PERCENTAGE TO APPLY TO CHARGES FOR ANY INDIVIDUAL THAT IS SELF-PAY AT THE TIME OF BILLING. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 11 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - COLUMBIA HILLS FAMILY MEDICINE | ||||
| 1620 E 12TH STREET | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 2 - RIVERVIEW INTERNAL MEDICINE | ||||
| 1825 E 19TH STREET | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 3 - WATER'S EDGE INTERNAL MEDICINE | ||||
| 551 LONE PINE BLVD STE 201 | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 4 - COLUMBIA CREST FAMILY MEDICINE | ||||
| 1935 E 19TH STREET | THE DALLES | OR | 97058 | HOSPITAL BASED CLINIC |
| 5 - COLUMBIA RIVER WOMEN'S CENTER | ||||
| 1810 E 19TH STREET STE 209 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 6 - MCMC SPORTSORTHOPAEDIC MEDICINE | ||||
| 551 LONE PINE BLVD STE 302 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 7 - WATER'S EDGE CARDIOLOGY | ||||
| 551 LONE PINE BLVD STE 303 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 8 - MCMC OCCUPATIONAL HEALTH | ||||
| 1815 EAST 19TH STREET SUITE 2 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 9 - COLUMBIA CREST DERMATOLOGY | ||||
| 1935 E 19TH STREET STE 110 | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 10 - GORGE UROLOGY | ||||
| 1805 E 19TH STREET | THE DALLES | OR | 97058 | NON-HOSPITAL BASED CLINIC |
| 11 - GORGE UROLOGY | ||||
| 810 12TH STREET | HOOD RIVER | OR | 97031 | NON-HOSPITAL BASED CLINIC |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | TRACK DIRECT LABOR AND OTHER COSTS IN EACH CATEGORY FOR ALL PATIENT SEGMENTS. IF ONLY REVENUE INFORMATION WAS AVAILABLE, A COST/CHARGE RATIO WAS APPLIED TO THE ESTIMATED COSTS |
| PART I, LINE 7: | COST-TO-CHARGE RATIO WAS UTILIZED; CCR WAS DERIVED FROM CALCULATION USED IN 2015 AUDITED FINANCIALS |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MCMC PROMOTES THE HEALTH OF THE COMMUNITIES WE SERVE BY PARTICIPATING IN REGIONAL EMERGENCY PREPAREDNESS PROGRAMS (PANDEMIC, NATURAL DISASTERS, AREA AND STATE TRAUMA ADVISORY BOARDS) AND DRILLS; BY SERVING AS AN ADVOCATE FOR THE COMMUNITY WITH REGARD TO LOCAL, STATE-WIDE AND REGIONAL HEALTH INITIATIVES; ACTING IN ADVISORY CAPACITY WITH OTHER LOCAL, STATE AND REGIONAL ORGANIZATIONS IN ORDER TO CREATE, ACCESS AND PROVIDE SERVICES OTHERWISE NOT AVAILABLE TO THE COMMUNITY; WORKING WITH THE LOCAL COMMUNITY COLLEGE AND EMS TO EDUCATE AND TRAIN FUTURE HEALTHCARE WORKERS BY PROVIDING JOB SHADOWING AND MENTORING PROGRAMS AS WELL AS DONATED SUPPORT TO THE COLLEGE FOR SPECIFIC NURSING PROGRAMS AND PROVIDING IN-KIND STAFF DONATED HOURS TO LOCAL SCHOOL ATHLETIC FUNCTIONS IN A MEDICAL CAPACITY (INJURED STUDENTS.) |
| PART III, LINE 2: | DESCRIBES ALLOWANCE FOR BAD DEBT EXPENSE AT GROSS CHARGE. THE ESTIMATE IS BASED PRIMARILY ON THE MEDICAL CENTER'S HISTORICAL COLLECTION EXPERIENCE, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY AND THE EFFECTIVENESS OF COLLECTIONS EFFORTS. BAD DEBT COST IS CALCULATED BY APPLYING THE HOSPITAL'S COST TO CHARGE RATIO |
| PART III, LINE 3: | WE COMPARED AMOUNTS ALLOWED FOR CHARITY CARE TO TOTAL CHARGES TO CALCULATE AN ESTIMATED RATE. |
| PART III, LINE 4: | DESCRIPTION OF BAD DEBT POLICY CAN BE FOUND ON PAGE 8 OF THE 2015 FINAL AUDITED FINANCIAL STATEMENTS |
| PART III, LINE 8: | MEDICARE COST REPORT COST TO CHARGE RATIO METHODOLOGY IS USED TO DETERMINE THE ALLOWABLE MEDICARE COSTS. MID-COLUMBIA MEDICAL CENTER CONTINUES TO PROVIDE CLINICAL SERVICES TO MEDICARE PATIENTS AT A DEFICIT AS PART OF OUR COMMITMENT TO THE RESIDENTS OF THE COMMUNITIES WE SERVE. THIS DEFICIT IS CONSISTENT WITH OUR TAX-EXEMPT STATUS AND INTERNAL MISSION TO PROVIDE COMMUNITY BASED HEALTHCARE REGARDLESS OF PATIENTS' ABILITY TO PAY. |
| PART III, LINE 9B: | IN CASES WHERE PATIENT HAS QUALIFIED FOR FULL OR PARTIAL CHARITY CARE, THE AMOUNT IS WRITTEN DOWN IN THE PATIENT ACCOUNT AND NO ATTEMPT IS MADE TO COLLECT THE AMOUNT WRITTEN DOWN. |
| PART VI, LINE 2: | COMMUNITY BENEFIT PRIORITIES AND ALLOCATIONS ARE GUIDED BY A COMMUNITY ASSESSMENT PROCESS WHICH UTILIZES QUANTITATIVE AND QUALITATIVE DATA OBTAINED FROM INTERNAL SOURCES AS WELL AS ASSESSMENT DATA FROM KEY COMMUNITY PARTNERS. MID-COLUMBIA MEDICAL CENTER PARTICIPATED AS A MEMBER OF THE COLUMBIA GORGE HEALTH COUNCIL (CGHC) IN A COLLABORATIVE NEEDS ASSESSMENT WHICH INCLUDED INPUT FROM SIX COUNTY HEALTH DEPARTMENTS, FOUR HOSPITALS, THE LOCAL COORDINATED CARE ORGANIZATION, SOCIAL SERVICES AGENCIES IN THE REGION, HEALTH CARE PROVIDERS IN THE SERVICE REGION AND CONSUMERS REPRESENTATIVE OF THE SAME. DETAILS ON THE METHODOLOGY, PARTICIPANTS AND REGIONAL RESULTS ARE ADDRESSED IN THE COLUMBIA GORGE REGIONAL COMMUNITY HEALTH ASSESSMENT AGENCY REPORT AND HEALTH CARE PROFESSIONAL SESSIONS WERE CONDUCTED IN ORDER TO CAPTURE AND RANK THE PRIMARY PERCEIVED NEEDS IN THE GORGE REGION. OVERALL NEEDS IDENTIFIED WERE ADEQUATE INCOME, STABLE HOUSING, FOOD, TRANSPORTATION AND HEALTH PREVENTION AND BOTH MEDICAL AND BEHAVIORAL HEALTH. ACCESS TO CARE WAS AN ADDITIONAL REGION-WIDE IDENTIFIED ISSUE.HEALTH OUTCOMES AND FACTORS OF PARTICULAR CONCERN IN WASCO COUNTY INCLUDE A HIGH RATE OF CHRONIC DISEASE, PREVALENCE OF ADULT AND CHILD OBESITY, TEEN PREGNANCY, LIMITED ACCESS TO HEALTHY FOODS, HIGH SCHOOL GRADUATION RATE AND A RELATIVELY HIGH PERCENTAGE OF THE POPULATION REPORTING INADEQUATE SOCIAL SUPPORT. |
| PART VI, LINE 3: | OUR PATIENT AND VISITOR SERVICES AND PATIENT ACCOUNTS STAFF TAKE AN ACTIVE ROLE IN ASSISTING LOW-INCOME AND UNDER- / UN-INSURED PATIENTS (THERE ARE SOME EXEMPTIONS IN PLACE TO THE INDIVIDUAL MANDATE REQUIRED BY THE AFFORDABLE CARE ACT) WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. APPLICATIONS (IN ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS IN BOTH THE HOSPITAL AND THE OUTPATIENT CLINICS. THIS APPLICATION PACKET OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION FOR ASSISTANCE WITH ENROLLMENT. |
| PART VI, LINE 4: | MID-COLUMBIA MEDICAL CENTER (MCMC) IS LOCATED IN THE DALLES, WASCO COUNTY, OREGON, WITH THE POPULATION OF WASCO COUNTY AT 25,775. MCMC SERVES A WIDE GEOGRAPHIC AREA OF RURAL NORTH CENTRAL OREGON ALONG THE COLUMBIA RIVER. THIS SERVICE AREA INCLUDES WASCO, SHERMAN AND GILLIAM COUNTIES IN OREGON AND KLICKITAT COUNTY IN WASHINGTON STATE FOR A COMBINED POPULATION TOTAL OF 50,340. MEDIAN INCOMES AND ETHNIC DEMOGRAPHICS VARY BY GEOGRAPHIC LOCATION. 2015 CENSUS DATA SHOWS MEDIAN INCOMES RANGE FROM $39,960 TO $46,490.WASCO COUNTY HAS THE LARGEST ETHNIC DIVERSITY WITH A DISTRIBUTION THAT IS 78% WHITE, 17% HISPANIC/LATINO, 4% AMERICAN INDIAN/ALASKA NATIVE AND 1% OTHER, STATISTICS WHICH REMAIN RELATIVELY UNCHANGED FROM 2014. SEVENTEEN PERCENT OF THE POPULATION LIVES BELOW THE POVERTY LEVEL AND 15% OF THE POPULATION UNDER THE AGE OF 65 IS UNINSURED. ADDITIONAL PUBLISHED DATA FROM THE OREGON HEALTH AUTHORITY CITES DECEMBER 31, 2014 MEDICAID PROGRAM ENROLLMENT IN WASCO COUNTY AT 7,563, AND 8,015 AT JULY 15, 2016, AN INCREASE OF 6%.IN ADDITION TO THE YEAR ROUND POPULATION, THE DALLES EXPERIENCES AN INFLUX OF OVER 15,000 SEASONAL WORKERS IN SUPPORT OF THE HARVEST OF OUR AGRICULTURAL ECONOMY. |
| PART VI, LINE 5: | MID-COLUMBIA MEDICAL CENTER IS A MISSION-DRIVEN ORGANIZATION WHOSE PURPOSE IS:* TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE* TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE MET ENTHUSIASTICALLY * TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE LIVE * TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTHCAREBOARD AND SENIOR EXECUTIVE LEADERSHIP ARE ACTIVELY INVOLVED IN PRIORITIZATION OF COMMUNITY INITIATIVES. A FULL-TIME DIRECTOR OVERSEES IMPLEMENTATION OF PROGRAMS AND ACTS AS THE PRIMARY LIAISON IN COMMUNITY COLLABORATIONS. DISCUSSION AND RECOMMENDATION OF COMMUNITY BENEFIT FOCUS AREAS CENTERS AROUND FIVE KEY COMPONENTS: ALIGNMENT WITH THE ORGANIZATION'S STRATEGIC PLAN; LIKELIHOOD OR FEASIBILITY OF HAVING A MEASURABLE IMPACT ON THE ISSUE; ALIGNMENT WITH CORE ORGANIZATIONAL COMPETENCIES; EFFICIENT ALLOCATION OF RESOURCES AND ALIGNMENT WITH PARTNERS WHO HAVE RESOURCES ALLOCATED TOWARD THE ISSUE. PREVENTION AND EDUCATIONADULT AND CHILDHOOD OBESITY* MID-COLUMBIA MEDICAL CENTER PARTNERS WITH THOSE IN THE COMMUNITY SEEKING TO IMPROVE OR ENHANCE THEIR HEALTH THROUGH LIFESTYLE CHANGES AND CHOICES, PARTICULARLY IN THE AREAS OF OBESITY AND HEART DISEASEPLANETREE HEALTH RESOURCE CENTER" IN ADDITION TO ISSUING THOUSANDS OF FREE ADMISSION PACKETS TO INPATIENTS, PHRC PROVIDED 60 BLOOD PRESSURE SCREENINGS IN 2015" 7,064 COMMUNITY MEMBERS TOOK ADVANTAGE OF FREE SERVICES AT PHRC" 181 PEOPLE ATTENDED THE FREE PHRC LECTURE SERIES WHICH INTRODUCED THE FOLLOWING TOPICS: LIVING WITH CHRONIC PAIN: TOOLS FOR MANAGEMENT MENTAL ILLNESS AND THE FAMILY: HOW TO COPE THIS AGING BODY COULD YOU REPEAT THAT? HEARING LOSS AND PREVENTIONDIABETES / OBESITY" MCMC HAS A ROBUST DIABETES EDUCATION OUTREACH FOCUS PROVIDING EDUCATIONAL SESSIONS THROUGHOUT OUR COMMUNITY AND SERVICE AREA. IN 2015 MCMC PROVIDED FOUR SCHOLARSHIPS TO LOW INCOME FAMILIES ATTENDING THE HEALTHY WEIGHT SOLUTIONS PROGRAM, WHICH PROVIDED NUTRITIONAL COUNSELING, HEALTHY COOKING DEMONSTRATIONS, INDIVIDUAL COUNSELING AND OVER 90 HOURS OF GROUP EDUCATIONGO RED FOR WOMEN'S HEART HEALTH" MCMC SPONSORS THIS EVENT EACH YEAR; IN 2015 255 REGISTRANTS PARTICIPATED IN A HEART EXPO/HEART WALK; OVER 150 REGISTRANTS PARTICIPATED IN THE HEART TRUTH WALK/RUN |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OR |
| LINE 5 CONTINUATION | PATIENT REHABILITATION SERVICES" PATIENT REHABILITATION SERVICES PROVIDED COMMUNITY EDUCATION AND ASSISTANCE IN THE DECISION-MAKING PROCESS FOR COMMUNITY MEMBERS CONSIDERING TOTAL JOINT REPLACEMENT" 70 PARTICIPANTS ATTENDED THE FREE MOMMY WELLNESS CLASSES; AN INTERDISCIPLINARY PROGRAM FOR PREGNANT AND NEW MOTHERS WITH CHILDREN UP TO TWO YEARS OF AGE, ITS PURPOSE IS TO PROVIDE EDUCATION AND EXERCISE DESIGNED TO PROMOTE HEALTHY LIFESTYLE HABITS FOR MOTHER AND CHILD. THE PROGRAM ALSO ADDRESSES BABY SIGN LANGUAGE AND DEVELOPMENT, PELVIC HEALTH FOR MOTHERS, BABY-MOTHER BONDING AND LACTATION SUPPORT. MOMMY WELLNESS TARGETS LOW INCOME, MINORITY AND UNDER-SERVED WOMEN AND THEIR YOUNG CHILDREN" PERSISTENT PAIN EDUCATION PROGRAM IS AN EIGHT-WEEK CLASS WHICH PROVIDES EDUCATION ON PAIN NEUROSCIENCE, ADAPTIVE COPING STRATEGIES, NUTRITION, MINDFULNESS, PROPER MEDICATION AND SLEEP HYGIENE TO PEOPLE WHO ARE DEALING WITH CHRONIC PAIN ISSUES. OVER 130 COMMUNITY MEMBERS ATTENDED THE SERIES " STEPS TO WELLNESS, TWO 90-MINUTE AND THREE 60-MINUTE TALKS GIVEN TO COMMUNITY MEMBERS AND PROVIDERS TO HELP THEM BETTER UNDERSTAND PAIN MANAGEMENT AND THE IMPORTANCE OF EDUCATION AND EXERCISE TO REACH THE GOAL OF LESSENING RELIANCE ON OPIATES. THE SERIES TARGETED MEDICAID AND MEDICARE RECIPIENTS AS WELL AS THE HISPANIC COMMUNITYFEMALE & FABULOUS FAIR" NOW IN ITS SECOND YEAR, THIS FREE HEALTH FAIR FOR WOMEN WAS ATTENDED BY 278 PARTICIPANTS; THE FAIR PROVIDED YOGA THERAPY CLASSES, HEALTHY COOKING CLASSES, CIRCUIT TRAINING, SKIN CHECKS WITH AN ON-STAFF DERMATOLOGIST, BREAST CARE, HORMONE REPLACEMENT THERAPY, WEIGHT LOSS AND NUTRITION, GENETICS, COMMUNICATION, SKIN CARE AND SKIN CANCER PREVENTION AND MINDFULNESS/SELF-CARE CLASSES |
| LINE 5 CONTINUATION | POVERTY AND UNINSUREDOUR PATIENT AND VISITOR SERVICES AND PATIENT ACCOUNTS STAFF TAKE AN ACTIVE ROLE IN ASSISTING LOW-INCOME AND UNDER- / UN-INSURED PATIENTS (THERE ARE SOME EXEMPTIONS IN PLACE TO THE INDIVIDUAL MANDATE REQUIRED BY THE AFFORDABLE CARE ACT) WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. APPLICATIONS (IN ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS IN BOTH THE HOSPITAL AND THE OUTPATIENT CLINICS. THIS APPLICATION PACKET OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION FOR ASSISTANCE WITH ENROLLMENT.OTHER MEANINGFUL CONTRIBUTIONS IN THE YEAR 2015" ANNUAL COMMUNITY DRUG-TAKE BACK: MID-COLUMBIA MEDICAL CENTER, IN PARTNERSHIP WITH LOCAL LAW ENFORCEMENT, YOUTH THINK AND TRI-COUNTY HAZARDOUS WASTE & RECYCLING, OFFERS FREE DROP-OFF OF HOUSEHOLD PRESCRIPTION, OVER THE COUNTER, VITAMIN/SUPPLEMENTS AND PET MEDICINES" MCMC PRODUCES A QUARTERLY HEALTH MAGAZINE (WELL AWARE) DISTRIBUTED TO OVER 17,000 HOUSEHOLDS THROUGHOUT THE SURROUNDING COMMUNITY, AT A COST OF APPROXIMATELY $95,000" MCMC FACILITATES A VARIETY OF SUPPORT GROUPS ON A REGULAR BASIS, INCLUDINGO MONTHLY STROKE CLUB O MONTHLY FAMILY SUPPORT CLASSES O HEALTHY WEIGHT SOLUTIONS O MONTHLY PROSTATE CANCER SUPPORT GROUPO REACH FOR RECOVERY - BREAST CANCER SUPPORT GROUPO PARKINSON'S SUPPORT GROUP " CAR SEAT EVALUATIONS, BIKE HELMET PROGRAMS AND TRAUMA NURSES TALK TOUGH ARE OFFERED ANNUALLY AT MAJOR MCMC AND OTHER COMMUNITY EVENTS" WITH A WIDELY DIVERSE ETHNIC POPULATION IN THE SERVICE AREA, INTERPRETATION SERVICES ARE IN HIGH DEMAND. MCMC IMPLEMENTED AUDIO / VIDEO REMOTE INTERPRETING TECHNOLOGY TO MEET LANGUAGE NEEDS IN THE HOSPITAL 24/7 TO ASSIST PATIENTS SEEKING CARE THROUGHOUT OUR ORGANIZATION AND TO ANY OTHER LOCAL HEALTH SERVICE PROVIDER, REGARDLESS OF AFFILIATION WITH MCMC. SPANISH SPEAKING STAFF REMAIN AVAILABLE FOR NON-MEDICAL INTERPRETATION SERVICES AT BOTH THE HOSPITAL AND OUTPATIENT CLINICS. MCMC IS WORKING TO CERTIFY QUALIFIED STAFF AS MEDICAL INTERPRETERS IN ORDER TO MEET SPECIFIC STATE REGULATIONS AND GUIDELINES" MCMC PROVIDES MENTORING AND INTERNSHIP PROGRAMS DESIGNED TO HELP TRAIN EXISTING AND FUTURE CARE PROVIDERS SUCH AS PHARMACY TECHNICIANS, MEDICAL ASSISTANTS, HEALTH INFORMATION MANAGEMENT STUDENTS, CHILD CARE PROVIDERS, RADIOLOGICAL TECHNICIANS, NURSES AND RURAL HEALTH EMS PROVIDERS " PHYSICIANS AND NURSES PROVIDE ACCESS TO FREE OR REDUCED COST PRIMARY CARE; MCMC ALSO PROVIDES SCHOOL NURSING SERVICES AT THE ELEMENTARY AGE LEVEL FOR LOCAL SCHOOLS" PROVIDES SUPPORT FOR THE AMERICAN RED CROSS BLOOD DRIVES" ENCOURAGES STAFF TO VOLUNTEER TO MAKE A DIFFERENCE THROUGH SERVICE TO MEMBERS OF THE COMMUNITY" PROVIDES FREE MEETING FACILITIES FOR VARIOUS CHARITABLE, CIVIC AND SUPPORT GROUPS SOCIAL DETERMINANTS OF HEALTHMCMC IS INVOLVED IN A VARIETY OF COMMUNITY AND COALITION BUILDING AND HEALTH ADVOCACY ACTIVITIES REGARDING SUCH SOCIAL DETERMINANTS AS: HEALTH AS FOOD SECURITY, HOUSING AND TRANSPORTATION. THE REGIONAL COMMUNITY ACTION COUNCIL BEGAN PRIORITIZING AN IMPLEMENTATION STRATEGY AROUND THESE TOPICS BEGINNING IN 2014; MCMC IS A PRIMARY PARTNER IN THOSE EFFORTS. THE HOSPITAL ALSO PARTICIPATES AS A MEMBER OF THE COLUMBIA GORGE HEALTH COUNCIL (CGHC) IN PROVIDING OVERSIGHT AND GOVERNANCE OF THE COORDINATED CARE ORGANIZATION FORMED BY PACIFICSOURCE COMMUNITY SOLUTIONS (PACIFICSOURCE.) CGHC IS A NONPROFIT CORPORATION COMPRISED OF THE MEDICAL CENTER, WASCO AND HOOD RIVER COUNTIES, CENTRAL OREGON INDEPENDENT PRACTICE ASSOCIATION, INC., ONE COMMUNITY HEALTH, PACIFICSOURCE, PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL AND AT-LARGE MEMBERS OF THE COMMUNITY |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| MID-COLUMBIA HEALTH FOUNDATION | |||||||
| 1700 E 19TH STREET | THE DALLES | OR | 97058 | 930854433 | 501(C)(3) | $50,000 | TO PROVIDE FUNDS FOR THE RENOVATION OF THE DALLES HIGH SCHOOL GYM |
| GORGE GROWN FOOD NETWORK | |||||||
| PO BOX 752 | HOOD RIVER | OR | 97031 | 262910949 | 501(C)(3) | $10,000 | TO SUPPORT LOCAL FOOD NETWORK AND LOCAL FARMERS |
| CHERRY CITY CRUSH | |||||||
| PO BOX 1912 | THE DALLES | OR | 97058 | 320330783 | 501(C)(3) | $5,000 | SUPPORT OF ATHLETIC LEAGE |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAUL CARDOSI MD | ||||||||||||||
| SECRETARY | $251,204 | $0 | $18,466 | $0 | $0 | $0 | $13,250 | $0 | $15,244 | $0 | $298,164 | $0 | $0 | $0 |
| DUANE FRANCIS | ||||||||||||||
| PRESIDENT & CEO | $0 | $631,127 | $0 | $41,700 | $0 | $0 | $0 | $120,316 | $0 | $30,736 | $0 | $823,879 | $0 | $0 |
| DONALD ARBON | ||||||||||||||
| CFO & VP FINANCE | $0 | $225,088 | $0 | $500 | $0 | $0 | $0 | $11,427 | $0 | $17,968 | $0 | $254,983 | $0 | $0 |
| REGINA ROSE | ||||||||||||||
| VP CHIEF NURSING OFFICER | $183,716 | $0 | $25 | $0 | $0 | $0 | $9,470 | $0 | $22,583 | $0 | $215,794 | $0 | $0 | $0 |
| WILLIAM HAMILTON MD | ||||||||||||||
| VP MEDICAL AFFAIRS | $380,974 | $0 | $7,381 | $0 | $0 | $0 | $13,250 | $0 | $22,617 | $0 | $424,222 | $0 | $0 | $0 |
| DIANNE STORBY | ||||||||||||||
| EXEC VP OF OPERATIONS | $0 | $289,141 | $0 | $500 | $0 | $0 | $0 | $13,250 | $0 | $18,947 | $0 | $321,838 | $0 | $0 |
| ERICK LARSON | ||||||||||||||
| VP CHIEF INFORMATION OFFIC | $0 | $175,838 | $0 | $25 | $0 | $0 | $0 | $9,125 | $0 | $17,017 | $0 | $202,005 | $0 | $0 |
| XINYU STEVE FU | ||||||||||||||
| PHYSICIAN | $701,611 | $0 | $25 | $0 | $0 | $0 | $13,250 | $0 | $16,544 | $0 | $731,430 | $0 | $0 | $0 |
| JOHN SCHWARTZ | ||||||||||||||
| PHYSICIAN | $551,496 | $0 | $25 | $0 | $0 | $0 | $13,250 | $0 | $10,938 | $0 | $575,709 | $0 | $0 | $0 |
| KEITH STELZER | ||||||||||||||
| PHYSICIAN | $592,802 | $0 | $25 | $0 | $0 | $0 | $13,250 | $0 | $14,044 | $0 | $620,121 | $0 | $0 | $0 |
| GARY GINGRICH | ||||||||||||||
| PHYSICIAN | $456,362 | $0 | $25 | $0 | $0 | $0 | $13,250 | $0 | $13,438 | $0 | $483,075 | $0 | $0 | $0 |
| MARK CULLEN | ||||||||||||||
| PHYSICIAN | $679,394 | $0 | $3,989 | $0 | $0 | $0 | $13,250 | $0 | $8,928 | $0 | $705,561 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | DUANE FRANCIS - $107,066 |
| PART I, LINE 6 | THE INCENTIVE COMPENSATION PLAN FOR THE QUALIFIED PERSON WAS BASED LARGELY ON NET PROFESSIONAL FEES GENERATED DIRECTLY BY THE QUALIFIED PERSON, COMMON PRACTICE FOR EMPLOYED PHYSICIANS. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (3 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd | Loan To OrganizationLoanToOrganizationInd |
|---|---|---|---|---|---|---|---|
| HEALTH CARE FOR THE MID-COLUMBIA REGION | |||||||
| DIRECTLY CONTROLLING ENTITY | OPERATING LOAN | Yes (X) | $82,486 | 0 | 0 | 0 | |
| MID-COLUMBIA HEALTH FOUNDATION | |||||||
| RELATED TO MID-COLUMBIA HEALTH FOUNDATION BY COMMON PARENT ORGANIZATION | OPERATING EXPENSES | $40,760 | 0 | 0 | 0 | Yes (X) | |
| DRY HOLLOW PROFESSIONAL CENTER INC | |||||||
| WHOLLY OWNED SUBSIDIARY OF HEALTH CARE, THE CONTROLLING ENTITY | OPERATING LOAN | $67,222 | 0 | 0 | 0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $190,468 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | HEALTH CARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE RETURN IS SUBMITTED TO THE BOARD OF TRUSTEES FOR REVIEW. UPDATES ARE MADE AS NECESSARY BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | WE ANNUALLY REQUIRE ALL OFFICERS AND DIRECTORS TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR AN OFFICER OR DIRECTOR WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE INDIVIDUAL COULD REMAIN AN OFFICER OR DIRECTOR. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS JUST DESCRIBED AND THEN VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS DETERMINED USING A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | AS REQUESTED. |
| FORM 990, PART XI, LINE 9: | INCREASE IN RESTRICTED NET ASSETS 16,274. INCOME FROM PASSTHROUGH ENTITIES -129,851. |
| FORM 990, PART XI, LINE 2C | THE RESPONSIBILITY AND PROCESS FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MID-COLUMBIA HEALTH FOUNDATION | ||||||||||
| 1700 E 19TH STREET | THE DALLES | OR | 97058 | 930854433 | SUPPORT MID-COLUMBIA MEDICAL CENTER | OR | 501(C)(3) | LINE 7 | HEALTH CARE FOR THE MID-COLUMBIA REGION | Yes (1) |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||||||||||
| 1700 E 19TH STREET | THE DALLES | OR | 97058 | 930847905 | HEALTH CARE SERVICES | OR | 501(C)(3) | LINE 11C, III-FI | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LONE PINE HEALTH & WELLNESS CENTER LLC | ||||||||||||
| 10210 194TH ST E101 | GRAHAM | WA | 98338 | 263919508 | MANAGE MEDICAL BUILDING/PROPERTY | OR | EXCLUDED 512-514 | $483,138 | $3,507,772 | 0 | 0 | 0.30000 |
| LPH&WC HOLDINGS LLC | ||||||||||||
| 1524 SHERMAN AVENUE | HOOD RIVER | OR | 97031 | 811236711 | RENTAL ACTIVITY | OR | UNRELATED | 0 | Yes (1) | |||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRY HOLLOW PROFESSIONAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 EAST 19TH STREET | AddressLine1Txt |
| City | THE DALLES | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930631350 | EIN |
| Primary Activities | RENTAL BUILDING | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MID-COLUMBIA HEALTH FOUNDATION | ||
| B | $50,000 | GRANTS PAID |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| C | $50,014 | GRANTS RECEIVED |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||
| D | $82,486 | LOANS TO RELATED PARTY |
| LONE PINE HEALTH & WELLNESS CENTER | ||
| D | $750,000 | LOAN GUARANTEE |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| E | $40,760 | LOAN FROM RELATED PARTY |
| DRY HOLLOW PROFESSIONAL CENTER | ||
| E | $67,222 | LOAN FROM RELATED PARTY |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||
| K | $203,763 | RENTAL AGREEMENT |
| LONE PINE HEALTH & WELLNESS CENTER | ||
| K | $1,592,000 | RENTAL AGREEMENT |
| DRY HOLLOW PROFESSIONAL CENTER | ||
| K | $134,346 | RENTAL AGREEMENT |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||
| M | $1,500,000 | MANAGEMENT CONTRACT |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| P | $540,530 | ACTUAL COSTS |
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