2014-11-14T16:12:33-06:00 2013-12-31 930418710 DELAP LLP 5885 MEADOWS ROAD NO 200 LAKE OSWEGO OR 97035 990 2013-01-01 930386936 MID-COLUMBIA MEDICAL CENTER MID- 5412961111 1700 E 19TH STREET THE DALLES OR 97058 DON ARBON CFO 5412961111 2014-11-14 1 MARK E EKLUND CPA P00156145 5036974118 2013 2015-11-30 17:44:51Z DUANE FRANCIS 1700 E 19TH STREET THE DALLES OR 97058 126504436 0 X WWW.MCMC.NET X 1984 OR TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. 7 5 1048 170 0 0 122949 149605 99323908 103979205 55392 923945 5083125 3739872 104585374 108792627 24598 528559 0 0 61228232 65417714 0 0 0 42373639 44201874 103626469 110148147 958905 -1355520 55256149 58043523 23949062 27339134 31307087 30704389 X TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. 0 0 98287456 528559 106433990 ACUTE HOSPITAL CARE: INPATIENT DAYS 7,430, INPATIENT REHAB DAYS 873, OUTPATIENT OBSERVATION DAYS 1,116, LABORATORY TESTS 190,158, IMAGING TESTS 28,092, HOME HEALTH EPISODES 1,582, EMERGENCY VISITS 14,850, ENDOSCOPY VISTIS 1,190, MEDICAL ONCOLOGY 9,526, OUTPATIENT SURGERIES 2,012, RADIATION ONCOLOGY OUTPATIENT PROCEDURES 8,212, TOTAL HOSPITAL OUTPATIENT VISITS 115,596 AND TOTAL OUTPATIENT CLINIC VISITS 92,647SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS. 98287456 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 152 0 1048 1 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 OR X MID-COLUMBIA MEDICAL CENTER 5412961111 1700 E 19TH STREET THE DALLES OR 97058 ROBERT LR BAILEY DIRECTOR 1.00 X 0 0 0 WALLACE WOLF JR DVM DIRECTOR 1.00 X 0 0 0 DAN BOLDT VICE CHAIR 1.00 X X 0 0 0 PAUL CARDOSI MD CHAIR 50.00 X X 229066 0 26028 ROB CARNAHAN SECRETARY 1.00 X X 0 0 0 CARINA SCHMIDT DIRECTOR 1.00 X 0 0 0 DUANE FRANCIS PRESIDENT & CEO 50.00 X X 0 604132 147703 DONALD ARBON CFO & VP FINANCE 50.00 X 0 221819 26204 REGINA ROSE VP CHIEF NURSING OFFICER 50.00 X 172861 0 24710 WILLIAM HAMILTON MD VP MEDICAL AFFAIRS 50.00 X 364267 0 28574 XINYU FU PHYSICIAN 50.00 X 409442 0 28770 JOHN SCHWARTZ PHYSICIAN 50.00 X 586068 0 23312 NATHAN ULLRICH PHYSICIAN 50.00 X 366710 0 26420 GARY GINGRICH PHYSICIAN 50.00 X 518085 0 24512 MARK CULLEN PHYSICIAN 50.00 X 581294 0 26486 3227793 825951 382719 89 0 1 0 OREGON HEALTH & SCIENCE UNIVERSITY 318 SW SAM JACKSON PARK RD PORTLAND OR 97239 PRO FEES FOR SPECIALTY CLINIC PROVIDERS 1056634 CORESOURCE INC PO BOX 83301 LANCASTER PA 17608 HEALTH INSURANCE CLAIMS PROCESSOR 669217 RADIATION ONCOLOGISTS PC 1400 NW IRVING ST STE 527 PORTLAND OR 97209 RADIATION ONCOLOGISTS 660643 QUEST DIAGNOSTICS 3 GIRALDA FARMS MADISON WI 07940 LAB SERVICES 390760 LOCUMTENENSCOM LLC PO BOX 405547 ATLANTA GA 30384 ANESTHESIOLOGY LOCUM TENANS 337798 22 113787 35818 149605 MEDICARE/MEDICAID PMNTS 900099 119641301 119641301 HOSPITAL REVENUE 900099 72559271 72559271 CLINIC REVENUE 900099 14984542 14984542 LESS:CHARITY CARE 900099 -6770731 -6770731 LESS:CONTRACTUALS-HOSP 900099 -99021233 -99021233 2586055 2586055 103979205 181026 181026 18454728 17639153 72656 815575 -72656 742919 742919 FITNESS & SPA CENTER 713940 1148068 1148068 CAFETERIA 722100 764618 764618 DAYCARE 624410 482785 482785 1344401 1306717 37684 3739872 108792627 106433990 0 2209032 528559 528559 3227793 2690665 537128 49892825 45643576 4249249 2331509 2118227 213282 6364768 5061350 1303418 3600819 3278042 322777 1500000 1500000 262443 262443 113427 113427 4952558 4856558 96000 4189955 3581752 608203 495340 495340 2995955 2746905 249050 883795 822516 61279 SUPPLIES 13785146 13610520 174626 PURCHASED SERVICES 5681575 4405211 1276364 BAD DEBT EXPENSE 5303387 5303387 OTHER 4038293 3144848 893445 110148147 98287456 11860691 0 14394895 3557670 11768882 12271185 148315 310370 1533975 1588025 1325501 2381258 62664554 45412569 17383347 17251985 4493765 13510354 668671 875041 1477493 1511102 2061305 4786533 55256149 58043523 8368939 9187691 11028431 10546546 0 116282 4551692 7488615 23949062 27339134 X 31081921 30535223 225166 169166 31307087 30704389 55256149 58043523 X -1355520 658822 94000 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1244561 317585 50466 516114 1096498 1260381 281874 31232 328926 1244561 1278290 413749 6603 438261 1260381 357664 32657 402 23127 367596 358543 13818 890 15587 357664 0.53530 0.33630 0.12840 0 1 1 562933 562933 12967267 8810275 4156992 4111018 1394089 2716929 44701232 35208205 9493027 322104 322104 17251985 INTEREST IN NET ASSETS OF MID-COLUMBIA MEDICAL FOUNDATION 169166 MISCELLANEOUS RECEIVABLES 4617367 4786533 CAPITAL LEASES 1187953 IBNR RESERVE 4597270 SETTLEMENT RESERVES 670864 DEFERRED COMPENSATION 1032528 7488615 X 103301101 -5269006 -5269006 108570107 222520 222520 108792627 104252461 0 104252461 5895686 5895686 110148147 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT FUND IS A QUASI-ENDOWMENT THAT FUNDS THE MID-COLUMBIA HEALTH FOUNDATION OPERATING EXPENSES - ENDING BALANCE $968,394. THE REMAINING ENDOWMENT FUNDS SUPPORT SEVERAL SCHOLARSHIPS. 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, 2013 AND 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT INCLUDED IN REVENUE ON THE FINANCIAL STATEMENTS -5,269,006. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS FROM MID-COLUMBIA HEALTH FOUNDATION 70,915. RESTRICTED CONTRIBUTIONS FROM OTHER SOURCES 12,200. EXPENSES REPORTED AS REVENUE 139,405. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT INCLUDED IN REVENUE ON THE FINANCIAL STATEMENTS 5,269,006. CONTRIBUTIONS TO MID-COLUMBIA HEALTH FOUNDATION FOR OPERATIONS 487,275. EXPENSES REPORTED AS REVENUE 139,405. 1 1 X 1 X 1 X 1 1 0 1 1 3471890 0 3471890 0.03150 11743861 7798860 3945001 0.03580 15215751 7798860 7416891 0.06730 28500 462609 9265 453344 0.00410 59 554754 0 554754 0.00500 3634565 3615388 19177 0.00020 36 21101 2800 18301 0.00020 3000 701346 68975 632371 0.00570 31595 5374375 3696428 1677947 0.01520 31595 20590126 11495288 9094838 0.08250 162607 162607 0.00150 25000 213288 213288 0.00190 1298 1298 0.00000 25000 377193 377193 0.00340 1 2473905 23512 27795500 29216415 -1420915 X 1 1 1 LONE PINE HEALTH & WELLNESS CENTER LLC MANAGE MEDICAL BUILDING/PROPERTY 0.30000 0.00000 0.00000 2 HEALTH FUTURE LLC ADMINISTRATIVE SERVICES PROVIDER AND GPO 0.16670 0.00000 0.00000 6 1 MID-COLUMBIA MEDICAL CENTER 1700 E 19TH STREET THE DALLES OR 97058 MCMC.NET 14-0500 X X X A 2 COLUMBIA HILLS FAMILY MEDICINE 1620 E 12TH STREET THE DALLES OR 97058 MCMC.NET 14-0500 RURAL HEALTH CLINIC B 3 COLUMBIA CREST CLINIC 1935 E 19TH STREET THE DALLES OR 97058 MCMC.NET 14-0500 RURAL HEALTH CLINIC B 5 INTERNAL MEDICINE CLINIC 1815 E 19TH STREET THE DALLES OR 97058 MCMC.NET 14-0500 RURAL HEALTH CLINIC B 7 WATERS EDGE CLINICS 551 LONE PINE BLVD THE DALLES OR 97058 WELLNESSATWATERSEDGE.COM 14-0500 RURAL HEALTH CLINIC B 8 RIVERVIEW INTERNAL MEDICINE CLINIC 1825 E 19TH STREET THE DALLES OR 97058 MCMC.NET 14-0500 RURAL HEALTH CLINIC B MID-COLUMBIA MEDICAL CENTER 1 X X X X X X X X 13 1 1 1 X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X X X X X 1 X 0 1 X 0 0 RURAL HEALTH CLINICS 1 X X X X X X X X 13 1 1 1 X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X 1 X 0 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: MID-COLUMBIA MEDICAL CENTER PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 2: COLUMBIA HILLS FAMILY MEDICINE, - FACILITY 3: COLUMBIA CREST CLINIC, - FACILITY 5: INTERNAL MEDICINE CLINIC, - FACILITY 7: WATERS EDGE CLINICS, - FACILITY 8: RIVERVIEW INTERNAL MEDICINE CLINIC 6 MCMCOHSU ORTHOPEDICS 551 LONE PINE BLVD THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC MCMCOHSU CARDIOLOGY 551 LONE PINE BLVD THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC COLUMBIA RIVER WOMEN'S CENTER 1810 E 19TH STREET THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC COLUMBIA CREST DERMATOLOGY 1935 E 19TH STREET STE 110 THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC GORGE UROLOGY 1805 E 19TH STREET THE DALLES OR 97058 NON-HOSPITAL BASED CLINIC GORGE UROLOGY 810 12TH STREET HOOD RIVER OR 97031 NON-HOSPITAL BASED CLINIC PART I, LINE 7: 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 ESTIMATE COSTS. PART I, LINE 7G: HOME HEALTH SERVICES, NET OF REVENUES AND CHARITY CARE/BAD DEBT ALREADY REPORTED IN PART I-7A OR III-A.2. FINANCIAL STATEMENTS REPORT BAD DEBT BASED ON GROSS CHARGES.$3,634,565 HOME HEALTH REVENUES$3,615,388 HOME HEALTH OPERATING EXPENSES$ (19,177) NET LOSSCOMMUNITY BENEFIT: MID-COLUMBIA MEDICAL CENTER (MCMC) IS THE SOLE PROVIDER OF VISITING HOME HEALTH SERVICES IN A FIVE-COUNTY RANGE IN OREGON AND WASHINGTON STATES; WITHOUT OUR SERVICES THERE WOULD BE NO IN-HOME CARE IN THE COMMUNITIES WE SERVE. 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. PART III, LINE 4: FOOTNOTE 1 IN THE AUDITED FINANCIAL STATEMENTS DESCRIBES ALLOWANCE FOR BAD DEBT EXPENSE AT GROSS CHARGE. THE ESTIMATE IS BASED PRIMARILY UPON 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 8: 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 A PATIENT HAS QUALIFIED FOR FULL OR PARTIAL CHARITY CARE, THE BALANCE OF THE PATIENT ACCOUNT BALANCE IS WRITTEN DOWN AND NO ATTEMPT IS MADE TO COLLECT THE AMOUNT ALLOWED FOR CHARITY CARE. 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 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, HEALTH PREVENTION AND BOTH MEDICAL AND BEHAVIORAL HEALTH. ACCESS TO CARE AND THE NUMBER OF UNINSURED ARE ADDITIONAL REGION WIDE IDENTIFIED ISSUES.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, LOW HIGH SCHOOL GRADUATION RATE AND A RELATIVELY HIGH PERCENTAGE OF THE POPULATION REPORTING INADEQUATE SOCIAL SUPPORT. PART VI, LINE 3: ALL FAMILY PRACTICE CLINIC STAFF ACTIVELY PROMOTES HEALTHY KIDS OPTIONS, WHICH PROVIDES INSURANCE FOR ALL CHILDREN IN THE STATE OF OREGON. BROCHURES ARE AVAILABLE IN ENGLISH AND SPANISH AT ALL FAMILY PRACTICE OFFICES. THE SCHOOL HEALTH NURSES MCMC SUPPLIES DISTRIBUTE THAT INFORMATION THROUGH THE LOCAL SCHOOLS.OUR PATIENT AND VISITOR SERVICES AND PATIENT ACCOUNTS DEPARTMENTS TAKE AN ACTIVE ROLE IN ASSISTING PATIENTS WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. BROCHURES IN ENGLISH AND SPANISH ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS DEPARTMENTS. THIS BROCHURE OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION. PART VI, LINE 4: MID-COLUMBIA MEDICAL CENTER (MCMC) IS LOCATED IN THE DALLES, WASCO COUNTY, OREGON, POPULATION 25,426. 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 50,249. MEDIAN INCOMES AND ETHNIC DEMOGRAPHICS VARY BY GEOGRAPHIC LOCATION. 2013 CENSUS DATA SHOWS MEDIAN INCOMES RANGE FROM $38,774 TO $46,453. WASCO COUNTY HAS THE LARGEST ETHNIC DIVERSITY WITH A DISTRIBUTION THAT IS 76% WHITE, 16% HISPANIC/LATINO, 4% AMERICAN INDIAN/ALASKA NATIVE AND 4% OTHER. 19% OF THE POPULATION IS BELOW THE POVERTY LEVEL, 22% OF THE POPULATION IS UNINSURED; OF ADULTS UNDER 65, 13% ARE DISABLED, 63% ARE WITH PUBLIC HEALTH INSURANCE AND 18% ARE UNINSURED.2013 TRUVEN HEALTH ANALYTICS DATA REPORTS THE CURRENT TOTAL POPULATION OF THE AREA IS EXPECTED TO INCREASE ABOUT 4% OVER THE NEXT FIVE YEARS, BUT NOT EQUALLY ACROSS COUNTIES. THE FIVE-YEAR PROJECTED GROWTH FOR THE HISPANIC/LATINO POPULATION IS 13%, MORE THAN FIVE TIMES PROJECTED GROWTH THAN ANY OTHER POPULATION. IT IS IMPORTANT TO NOTE THAT WITH THIS ESTIMATE THERE ARE A NUMBER OF UNDOCUMENTED PEOPLE WHO ARE INELIGIBLE FOR MANY PROGRAMS AND BENEFITS, PRESENTING ADDITIONAL CHALLENGES TO MEETING BASIC NEEDS AND PROVIDING ACCESS TO HEALTHCARE. WE CAN ANTICIPATE THAT A SIZEABLE PORTION OF THIS POPULATION WILL REMAIN UNINSURED.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 ALL LIVE. * TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTHCARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES:PREVENTION AND EDUCATIONADULT AND CHILDHOOD OBESITY* THE CENTER FOR MIND AND BODY MEDICINE AND MCMC DIETICIANS PARTNERED WITH LA NUESTRA COMUNIDAD SANA TO PROVIDE EXPERT INSTRUCTORS FOR A FAMILY WEIGHT LOSS PROGRAM (PASOS ADELANTE.) OVER 20 FAMILIES PARTICIPATED AND GRADUATED FROM THIS BENCHMARK PROGRAM ADDRESSING NUTRITION AND OBESITY IN THE HISPANIC/LATINO POPULATION, WITH SCHOLARSHIPS PROVIDED TO PARTICIPANTS UNABLE TO COVER THE EXPENSE OF THE PROGRAMMID-COLUMBIA MEDICAL CENTER HEALTH FAIR* 350 PEOPLE ATTENDED THE HEALTH FAIR, WITH 117 BLOOD DRAWS, 46 FLU SHOTS AND 75 BLOOD PRESSURE SCREENINGS PROVIDED FREE OF CHARGEPLANETREE HEALTH RESOURCE CENTER* IN ADDITION TO ISSUING THOUSANDS OF FREE INPATIENT ADMISSION PACKETS TO PATIENTS, PHRC PROVIDED 375 BLOOD PRESSURE SCREENINGS IN 2013* OVER 280 PEOPLE ATTENDED THE FREE PHRC LECTURE SERIES, WITH TOPICS RANGING FROM TREATMENT AND MANAGEMENT OF CHRONIC PAIN TO HEALTHY WEIGHT AND STRESS MANAGEMENT* OVER 7,700 HUNDRED COMMUNITY MEMBERS TOOK ADVANTAGE OF FREE SERVICES AT PHRCDIABETES* MCMC HAS A ROBUST DIABETES EDUCATION OUTREACH FOCUS PROVIDING EDUCATIONAL SESSIONS THROUGHOUT OUR COMMUNITY AND SERVICE AREA. IN 2013 OVER 200 COMMUNITY RESIDENTS ATTENDED PRESENTATIONS GIVEN THROUGHOUT OUR COMMUNITY. OUR ANNUAL DIABETES DISCOVERY DAY WAS ATTENDED BY OVER 225 PEOPLE FROM COMMUNITIES THROUGHOUT THE COLUMBIA GORGE. THIS FREE ANNUAL EVENT INCLUDED LECTURES BY PHYSICIANS, CERTIFIED DIABETES EDUCATORS AND DIETICIANS, WHO PRESENTED INFORMATION AND DEMONSTRATIONS ON THE LATEST RESEARCH, TREATMENTS, LIFESTYLE AND PREVENTION TIPS PROMOTING GOOD HEALTH FOR DIABETIC PATIENTS. FREE BLOOD SUGAR SCREENINGS WERE OFFERED BY MCMC LABORATORY STAFF AS WELL.POVERTY AND UNINSUREDALL FAMILY PRACTICE STAFF ACTIVELY PROMOTE HEALTHY KIDS OPTIONS, WHICH PROVIDES INSURANCE FOR ALL CHILDREN IN THE STATE OF OREGON. BROCHURES ARE AVAILABLE IN ENGLISH AND SPANISH AT ALL FAMILY PRACTICE OFFICES AND THE MCMC SCHOOL HEALTH NURSES DISTRIBUTE THAT INFORMATION IN THE LOCAL SCHOOLS. OUR PATIENT AND VISITOR SERVICES AND PATIENT ACCOUNTS DEPARTMENTS TAKE AN ACTIVE ROLE IN ASSISTING PATIENTS WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. APPLICATIONS (IN ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS. THIS APPLICATION PACKET OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION. OTHER MEANINGFUL CONTRIBUTIONS IN THE YEAR 2013MCMC FAMILY PRACTICE PROVIDERS PROVIDED OVER 300 FREE SPORTS PHYSICALS TO DISTRICT 21 STUDENTS IN MIDDLE AND HIGH SCHOOL.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 PRESCRIPTIONS, OVER THE COUNTER MEDICATIONS, VITAMIN/SUPPLEMENTS AND PET MEDICINES.MCMC PRODUCES A QUARTERLY HEALTH MAGAZINE DISTRIBUTED TO OVER 17,000 HOUSEHOLDS THROUGHOUT THE SURROUNDING COMMUNITY, AT A COST OF APPROXIMATELY $100,000.* MCMC FACILITATES A VARIETY OF SUPPORT GROUPS ON A REGULAR BASIS, INCLUDING O MONTHLY DIABETES SUPPORT GROUP FACILITATION O MONTHLY STROKE CLUB O MONTHLY FAMILY SUPPORT CLASSES O HEALTHY WEIGHT SOLUTIONS O MONTHLY PROSTATE CANCER SUPPORT GROUP O REACH FOR RECOVERY BREAST CANCER SUPPORT GROUP * CAR SEAT EVALUATIONS, BIKE HELMET PROGRAMS AND TRAUMA NURSES TALK TOUGH ARE OFFERED AT MAJOR MCMC AND OTHER COMMUNITY EVENTS* OVER 2,250 HOURS OF FREE INTERPRETATION SERVICES WERE PROVIDED TO ASSIST PATIENTS SEEKING CARE THROUGHOUT OUR ORGANIZATION AND TO ANY OTHER LOCAL HEALTH SERVICE PROVIDERS, REGARDLESS OF AFFILIATION WITH MCMC. MCMC ALSO IMPLEMENTED VIDEO REMOTE INTERPRETING TECHNOLOGY TO MEET ALL LANGUAGE NEEDS IN THE HOSPITAL 24/7.* SUBSIDY OF THE SCHOOL HEALTH SERVICES PROGRAM PROVIDES ADDITIONAL DIRECT SERVICE HOURS TO SERVE SPECIAL NEEDS STUDENTS IN THE LOCAL DISTRICT* 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 * OUR PRIMARY CARE CLINICS ARE ACTIVE PARTICIPANTS IN THE REACH OUT AND READ EARLY CHILDHOOD LITERACY PROGRAM, PROVIDING FREE BOOKS FOR PEDIATRIC PATIENTS SEEN IN OUR CLINICS* MCMC PARTNERS WITH BREAD AND BLESSINGS, CONTRIBUTING IN-KIND FOOD DONATIONS ON A MONTHLY BASIS. IN ADDITION, DEPARTMENTS/CLINICS AND INDIVIDUAL STAFF VOLUNTEER REGULARLY AT THE LOCAL COMMUNITY MEALS PROGRAM OVERSEEN BY ST. VINCENT DE PAUL SERVICES, BY PURCHASING, PREPARING AND SERVING FREE MEALS.SOCIAL DETERMINANTS OF HEALTHMCMC IS INVOLVED IN A VARIETY OF COMMUNITY AND COALITION BUILDING ACTIVITIES AND HEALTH ADVOCACY REGARDING SUCH SOCIAL DETERMINANTS OF HEALTH AS FOOD SECURITY, HOUSING AND TRANSPORTATION. THE NEWLY FORMED REGIONAL COMMUNITY ACTION COUNCIL WILL BE PRIORITIZING AN IMPLEMENTATION STRATEGY AROUND THESE TOPICS BEGINNING IN 2014; MCMC WILL BE A PRIMARY PARTNER IN THOSE EFFORTS. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 MID-COLUMBIA HEALTH FOUNDATION 1700 E 19TH STREET THE DALLES OR 97058 930854433 501(C)(3) 5000 TO PROVIDE FUNDS FOR SCHOLARSHIPS CONFLUENCES INC 1701 BROADWAY 144 VANCOUVER WA 98663 753008926 501(C)(3) 17748 COLUMBIA RIVER ART, NATURAL RESOURCE PRESERVATION, HERITAGE AND TOURISM CORRIDOR CIVIC AUDITORIUM HISTORIC PRESERVATION FOUNDATION 323 E FOURTH STREET THE DALLES OR 97058 300589189 501(C)(3) 10000 PRESERVATION OF COMMUNITY RESOURCE MID-COLUMBIA HEALTH FOUNDATION 1700 E 19TH STREET THE DALLES OR 97058 930854433 501(C)(3) 487275 OPERATING EXPENSES 3 0 PART I, LINE 2: AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR. X X X X X 0 1 0 0 0 1 0 0 0 PAUL CARDOSI MD CHAIR 168061 0 61005 0 0 0 11682 0 14346 0 255094 0 0 0 DUANE FRANCIS PRESIDENT & CEO 0 568607 0 35525 0 0 0 114705 0 32998 0 751835 0 0 DONALD ARBON CFO & VP FINANCE 0 221294 0 525 0 0 0 11310 0 14894 0 248023 0 0 REGINA ROSE VP CHIEF NURSING OFFICER 172836 0 25 0 0 0 8988 0 15722 0 197571 0 0 0 WILLIAM HAMILTON MD VP MEDICAL AFFAIRS 363742 0 525 0 0 0 12750 0 15824 0 392841 0 0 0 XINYU FU PHYSICIAN 409417 0 25 0 0 0 12750 0 16020 0 438212 0 0 0 JOHN SCHWARTZ PHYSICIAN 551043 0 35025 0 0 0 12750 0 10562 0 609380 0 0 0 NATHAN ULLRICH PHYSICIAN 366685 0 25 0 0 0 12900 0 13520 0 393130 0 0 0 GARY GINGRICH PHYSICIAN 498876 0 19209 0 0 0 12750 0 11762 0 542597 0 0 0 MARK CULLEN PHYSICIAN 581269 0 25 0 0 0 11906 0 14580 0 607780 0 0 0 PART I, LINE 4B DUANE FRANCIS - $101,955 PART I, LINE 6 THE INCENTIVE COMPENSATION PLAN OF $80,164 FOR THE QUALIFIED PERSON WAS BASED LARGELY ON NET PROFESSIONAL FEES GENERATED DIRECTLY BY THE QUALIFIED PERSON, COMMON PRACTICE FOR EMPLOYED PHYSICIANS. MIRIAM MCDONELL MD SPOUSE OF PAUL CARDOSI, M.D., BOARD MEMBER 60446 EMPLOYMENT 0 VICKI WOLF SPOUSE OF WALLACE WOLF, JR., D.V.M., DIRECTOR 60367 EMPLOYMENT 0 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: DECREASE IN RESTRICTED NET ASSETS -56,000. WRITE-OFF OF PAYABLE DUE TO AFFILIATE 150,000. FORM 990, PART XI, LINE 2C THE RESPONSIBILITY AND PROCESS FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. MID-COLUMBIA HEALTH FOUNDATION 1700 E 19TH STREET THE DALLES OR 97058 930854433 SUPPORT MID-COLUMBIA MEDICAL CENTER OR 501(C)(3) 7 HEALTH CARE FOR THE MID-COLUMBIA REGION 0 HEALTH CARE FOR THE MID-COLUMBIA REGION 1700 E 19TH STREET THE DALLES OR 97058 930847905 HEALTH CARE SERVICES OR 501(C)(3) 3 0 LONE PINE HEALTH & WELLNESS CENTER LLC 10210 194TH ST E101 GRAHAM WA 98338 263919508 MANAGE MEDICAL BUILDING/PROPERTY OR EXCLUDED 512-514 183856 3761109 0 0 0.30000 DRY HOLLOW PROFESSIONAL CENTER INC 1700 EAST 19TH STREET THE DALLES OR 97058 930631350 RENTAL BUILDING OR HEALTH CARE FOR THE MID-COLUMBIA REGION C 0 0 1 1 1 1 0 0 0 0 0 1 0 1 0 1 1 0 0 1 MID-COLUMBIA HEALTH FOUNDATION B 5000 GRANTS PAID MID-COLUMBIA HEALTH FOUNDATION C 113787 GRANTS RECEIVED HEALTH CARE FOR THE MID-COLUMBIA REGION E 31647 PAYABLES TO RELATED PARTY MID-COLUMBIA HEALTH FOUNDATION E 2439 LOANS FROM RELATED PARTY DRY HOLLOW PROFESSIONAL CENTER E 82196 PAYABLES TO RELATED PARTY HEALTH CARE FOR THE MID-COLUMBIA REGION K 137099 RENTAL AGREEMENT LONE PINE HEALTH & WELLNESS CENTER K 1522000 RENTAL AGREEMENT DRY HOLLOW PROFESSIONAL CENTER K 134346 RENTAL AGREEMENT HEALTH CARE FOR THE MID-COLUMBIA REGION M 1500000 MANAGEMENT CONTRACT MID-COLUMBIA HEALTH FOUNDATION O 301350 EMPLOYEE GROSS PAY MID-COLUMBIA HEALTH FOUNDATION P 185925 ACTUAL EXPENSES MID-COLUMBIA HEALTH FOUNDATION S 113787 ACTUAL EXPENSES LONE PINE HEALTH & WELLNESS CENTER D 2250000 LOAN GUARANTEE HEALTH CARE FOR THE MID-COLUMBIA REGION S 150000 WRITE-OFF RECEIVABLE