LEGACY SALMON CREEK HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LEGACY SALMON CREEK HOSPITAL (EIN 33-1065485)
Tax period
2012-04-01 to 2013-03-31
Filed
2014-02-18
IRS object ID
201410499349302056
Schema version
2012v2.0
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-02-18T15:46:11-08:00Timestamp
Tax Period End Date2013-03-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN331065485EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LEGACY SALMON CREEK HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLEGANameControl
Phone5034155600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12211 NE 139TH STREETAddressLine1
CityVANCOUVERCity
StateWAState
ZIP Code98686ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLINDA S HOFFName
TitleCFO & TREASURERTitle
Date Signed2014-02-18DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGEORGE J BROWN MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1C/O 1919 NW LOVEJOY STREETAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97209ZIPCode
FieldValueIRS element (for citing)
Gross Receipts228884853GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.LEGACYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionLegacy Salmon Creek Hospital (LSCH), established in 2005, provides acute and critical care in Vancouver, with 165 licensed beds. LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and three specialty clinics. LSCH provides a comprehensive range of inpatient, clinical and diagnostic services in numerous medical specialties and subspecialties. LSCH is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and achieve them Responsibility - Be good stewards of our resources, ensuring access to care for all Innovation - Be progressive in our thinking and actions Leadership - Serve aActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers875TotalNbrVolunteers
Total Gross UBI485997TotalGrossUBI
Net Unrelated Business Txbl Income-22951NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year30247ContributionsGrantsPriorYear
Contributions Grants Current Year168749ContributionsGrantsCurrentYear
Program Service Revenue Prior Year217539807ProgramServiceRevenuePriorYear
Program Service Revenue CY223060480ProgramServiceRevenueCY
Investment Income Prior Year1968268InvestmentIncomePriorYear
Investment Income Current Year4520993InvestmentIncomeCurrentYear
Other Revenue Prior Year-1160515OtherRevenuePriorYear
Other Revenue Current Year-1180488OtherRevenueCurrentYear
Total Revenue Prior Year218377807TotalRevenuePriorYear
Total Revenue Current Year226569734TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4372GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY4372GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year121724075SalariesEtcPriorYear
Salaries Etc Current Year128201299SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year86650471OtherExpensePriorYear
Other Expenses Current Year87555236OtherExpensesCurrentYear
Total Expenses Prior Year208378918TotalExpensesPriorYear
Total Expenses Current Year215760907TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9998889RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10808827RevenuesLessExpensesCY
Total Assets BOY278259891TotalAssetsBOY
Total Assets EOY289012354TotalAssetsEOY
Total Liabilities BOY34989594TotalLiabilitiesBOY
Total Liabilities EOY39039160TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY243270297NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY249973194NetAssetsOrFundBalancesEOY
Mission DescriptionLegacy Salmon Creek Hospital (LSCH), established in 2005, provides acute and critical care in Vancouver, with 165 licensed beds. LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and three specialty clinics. LSCH provides a comprehensive range of inpatient, clinical and diagnostic services in numerous medical specialties and subspecialties. LSCH is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and achieve them Responsibility - Be good stewards of our resources, ensuring access to care for all Innovation - Be progressive in our thinking and actions Leadership - Serve aMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense154729038Expense
Grants4372Grants
Revenue207947126Revenue
DescriptionLSCH was the State of Washington's first new hospital construction since 1979. The hospital opened in August 2005 with 165 licensed beds, all of which are single occupancy. LSCH provides a full array of hospital services, including surgery, diagnostics, inpatient and outpatient medical services, neonatal intensive care unit, pediatric, obstetrical, and emergency services. LSCH utilizes an electronic information system for medical records and physician order entry. Physicians are able to complete their entire patient records electronically and can remotely access patient records, including diagnostic images.In support of its mission, LSCH voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. During fiscal year 2013, LSCH provided financial assistance on approximately 13,751 patient accounts (of which 12% received discounts totaling 100% of costs) and resulted in LSCH incurring roughly $8,762,535 in uncompensated costs associated with this program. In addition to charity care, LSCH provides services under various states' Medicaid programs for financially needy patients Medicare beneficiaries, and other government programs for which the cost of treating these patients exceeds the government payments received. During fiscal year 2013, LSCH incurred approximately $20,915,469, $10,142,639 in uncompensated costs attributable to Medicaid, Medicare respectively. LSCH also provides a variety of other community benefit activities such as medical education, donations to other charitable entities, research, and other health improvement services, which totaled roughly $924,187 during fiscal year 2013.LSCH is part of Legacy, which collectively provided over $66 million, $119 million, $77 million, and $2 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2013. In addition, Legacy provided over $21 million in other community benefit activities during fiscal year 2013..Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense17426966Expense
Revenue15113354Revenue
DescriptionLSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and six specialty clinics in southwest Washington. LSCH utilizes an electronic information system for medical records and physician order entry. Physicians are able to complete their entire patient records electronically and can remotely access patient records, including diagnostic images.Description
FieldValueIRS element (for citing)
Total Program Service Expense172156004TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLINDA S HOFFNamePerson
Telephone Number5034155600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11919 NW LOVEJOY STREETAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97209ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
RT REV MICHAEL J HANLEY
BOARD MEMBER3.000.00X000
JOHN W WINTER JR
BOARD DIRECTOR4.000.00X000
STEPHEN NEWBERRY MD
BOARD DIRECTOR3.001.00X080000
CORLISS A MCKEEVER
BOARD DIRECTOR3.000.00X04990
DUANE C MCDOUGALL
BOARD DIRECTOR3.000.00X000
RONALD S KING
BOARD DIRECTOR4.000.00X000
LESLIE ROOT MD
BOARD DIRECTOR4.001.00X0214600
JEFFREY S GORDON
VICE CHAIR5.000.00X000X
JEFFREY D FULLMAN MD
BOARD DIRECTOR3.000.00X000
DIANE PINNEY
BOARD DIRECTOR4.000.00X000
ROBERT L CORNIE
BOARD DIRECTOR4.000.00X000
COLLEEN A CAIN
Chairman7.000.00X000X
SHERYL MANNING
BOARD DIRECTOR4.000.00X000
CHRISTOPHER S THOMING MD
BOARD DIRECTOR3.000.00X000
BISHOP DAVID BRAUER-RIEKE
BOARD DIRECTOR3.000.00X000
DAVID E EAGER
CFO & TREAS0.0040.00066166259796X
P CAMPBELL GRONER III
SR VP & SEC0.0040.000534857130283X
GEORGE J BROWN MD
President & CEO0.0040.0001450450381385X
LOW L LEWIS
SR. VP. CHIEF MEDICAL OFFICER0.0040.00045338363130X
JOHN J KENAGY
SR VP0.0040.00028975239269X
TERESA L HANDY
VP REVENUE CYCLE OPERATIONS40.000.00179842042606X
GLEN C LUTZ
SR VP0.0040.0001423608017X
MAUREEN A BRADLEY
SR VP0.0040.00029363839299X
EVERETT NEWCOMB III
SR VP0.0040.000691557186437X
SONJA O STEVES
SR VP0.0040.00038865995849X
TRENT S GREEN
SR VP0.0040.00042322275838X
CAROL A BRADLEY
SR VP0.0040.00042947981250X
GEORGE A CIOFFI MD
SR VP0.0040.00035559765241X
JONATHAN E AVERY
VP40.000.00426052084146X
FRED H COLEMAN
PHYSICIAN40.000.00390737026771X
JOHN G BUCKMASTER
PHYSICIAN40.000.00372714049810X
LANI GASKILL
NURSE EXECUTIVE40.000.00469087029540X
TIMOTHY J RODDY
PHYSICIAN40.000.00434796058879X
LIAN R SHAW
PHYSICIAN40.000.00465201018904X
PAMELA VUKOVICH
FORMER SR. VP & TREAS0.000.00023051186196X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2738429TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6375086TotalReportableCompFrmRltdOrgs
Total Other Compensation1622646TotalOtherCompensation
Number Individuals GT100 K165NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
THE VANCOUVER CLINIC INC
700 NE 87TH AVEVANCOUVERWA98664MEDICAL SERVICES705650
MEDLINE INDUSTRIES
PO BOX 121080 DEPT 1080DALLASTX75312MEDICAL SUPPLIES3744863
GE MEDICAL SYSTEMS
PO BOX 843553DALLASTX75284MEDICAL EQUIPMENT1268445
ELEKTA INC
PO BOX 404199ATLANTAGA30384MEDICAL SERVICES571850
COLUMBIA ANESTHESIA GROUP
PO BOX 5157VANCOUVERWA98668MEDICAL SERVICES505380
FieldValueIRS element (for citing)
Number Of Contractors GT100 K26NumberOfContractorsGT100K
Related Organizations168749RelatedOrganizations
Noncash Contributions8863NoncashContributions
Total Contributions168749TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
RETAIL PHARMACY485997485997
PATIENT PROGRAM REV530017613530017613
CONVENIENCE OF MEMBERS1533967$1,533,967
CONTRACTUAL ALLOWANCE-285166762-285166762
CHARITY CARE-23810335-23810335
FieldValueIRS element (for citing)
Total Program Service Revenue223060480TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4779083TotalRevenueColumn
Exclusion$4,779,083ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1134631Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2315119Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-1180488Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-1180488TotalRevenueColumn
Exclusion-$1,180,488ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities-258090Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-258090Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-258090TotalRevenueColumn
Related Or Exempt Function Income-258090RelatedOrExemptFunctionIncome

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column226569734TotalRevenueColumn
Related Or Exempt Function Income220782426RelatedOrExemptFunctionIncome
Unrelated Business Revenue485997UnrelatedBusinessRevenue
Exclusion$5,132,562ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4372Total
Program Services4372ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total732646Total
Program Services657205ProgramServices
Management And General75441ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total98397710Total
Program Services75274647ProgramServices
Management And General23123063ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8311507Total
Program Services5841238ProgramServices
Management And General2470269ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13278131Total
Program Services8760517ProgramServices
Management And General4517614ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7481305Total
Program Services5320097ProgramServices
Management And General2161208ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total144899Total
Program Services1063ProgramServices
Management And General143836ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total55500Total
Management And General55500ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2696750Total
Program Services2696750ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total27928957Total
Program Services26055693ProgramServices
Management And General1873264ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total476439Total
Program Services382318ProgramServices
Management And General94121ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total120273Total
Program Services83345ProgramServices
Management And General36928ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total111932Total
Program Services89820ProgramServices
Management And General22112ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14375529Total
Program Services11520220ProgramServices
Management And General2855309ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1236484Total
Program Services1005476ProgramServices
Management And General231008ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
TAXES WA B&O, USE & SALES32781812630576647605
PROVIDER TAX72544777254477
CONTRACT SERVICES1152105383101403210913
BAD DEBTS1513773215034367103365

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3217030Total
Program Services1233683ProgramServices
Management And General1983347ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total215760907Total
Program Services172156004ProgramServices
Management And General43604903ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY632448BOY
EOY194239EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY24602414BOY
EOY25179012EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY17502EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY13656BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1719104BOY
EOY1654144EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY562798BOY
EOY572648EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis336825886LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec141829747LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY205585180BOY
EOY194996139EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY41941457BOY
EOY63195838EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3202834BOY
EOY3202832EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY278259891BOY
EOY289012354EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13592026BOY
EOY15672361EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY21397568BOY
EOY23366799EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY34989594BOY
EOY39039160EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY243270297BOY
EOY249973194EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY243270297BOY
EOY249973194EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY278259891BOY
EOY289012354EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10808827ReconcilationRevenueExpenses
Reconcilation Other Changes-4105930ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewtrueAccountantCompileOrReview

Accountant Compile Or Review Basis AccountantCompileOrReviewBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
Org Belongs To Affiliated GroupXOrgBelongsToAffiliatedGroup

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals127249FilingOrganizationsTotals
Affiliated Group Totals163605AffiliatedGroupTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals127249FilingOrganizationsTotals
Affiliated Group Totals163605AffiliatedGroupTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals187471913FilingOrganizationsTotals
Affiliated Group Totals1186791417AffiliatedGroupTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals187599162FilingOrganizationsTotals
Affiliated Group Totals1186955022AffiliatedGroupTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals
Affiliated Group Totals1000000AffiliatedGroupTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals
Affiliated Group Totals250000AffiliatedGroupTotals
FieldValueIRS element (for citing)
Form4720 FiledfalseForm4720Filed

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus32000000CurrentYearMinus3
Current Year Minus22000000CurrentYearMinus2
Current Year Minus12000000CurrentYearMinus1
Current Year2000000CurrentYear
Total8000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$12,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus3263925CurrentYearMinus3
Current Year Minus2349418CurrentYearMinus2
Current Year Minus1288019CurrentYearMinus1
Current Year290854CurrentYear
Total1192216Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3500000CurrentYearMinus3
Current Year Minus2500000CurrentYearMinus2
Current Year Minus1500000CurrentYearMinus1
Current Year500000CurrentYear
Total2000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$3,000,000GrassrootsCeilingAmount

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance275304BeginningOfYearBalance
Contributions392109Contributions
Investment Earnings Or Losses267InvestmentEarningsOrLosses
Other Expenditures148370OtherExpenditures
End Of Year Balance519310EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance195066BeginningOfYearBalance
Contributions107966Contributions
Other Expenditures27728OtherExpenditures
End Of Year Balance275304EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance136521BeginningOfYearBalance
Contributions90600Contributions
Other Expenditures-32055OtherExpenditures
End Of Year Balance259176EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance58038BeginningOfYearBalance
Contributions152877Contributions
Other Expenditures74394OtherExpenditures
End Of Year Balance136521EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance8321BeginningOfYearBalance
Contributions86833Contributions
Other Expenditures37116OtherExpenditures
End Of Year Balance58038EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.59000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.41000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis10173635OtherCostOrOtherBasis
Book Value10173635BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis241094037OtherCostOrOtherBasis
Depreciation78058645Depreciation
Book Value163035392BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis30958OtherCostOrOtherBasis
Depreciation9907Depreciation
Book Value21051BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis84368882OtherCostOrOtherBasis
Depreciation63761195Depreciation
Book Value20607687BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1158374OtherCostOrOtherBasis
Book Value1158374BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings194996139TotalOfBookValueLandBuildings
Total Of Book Value Securities63195838TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
NONCURRENT WORKERS' COMP LIABILITY$322,000
NONCURRENT PENSION LIABILITY$23,027,297
COMPANY AFFILIATE PAYABLE$17,502
FieldValueIRS element (for citing)
Total Of Amounts23366799TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt225120000TotRevenueEtcAuditedFinclStmt
Revenue Subtotal225120000RevenueSubtotal
Other Revenues Not Included1449734OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1449734RevenueNotRptdOnFinStmt
Total Revenue Per Form990226569734TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt214420000TotExpensesEtcAuditedFinclStmt
Expenses Subtotal214420000ExpensesSubtotal
Other Expenses Not Included1340907OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1340907ExpensesNotRptdOnFinStmt
Total Expenses Per Form990215760907TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 4bPart XII, Line 4b: Other revenue amounts included on 990 but not included in F/SMEDICAL STAFF EXPENSE $438758 FOUNDATION DONATION $124865 OTHER EXPENSE $7032 GAIN / LOSS OF SALE OF ASSETS $-258090 PROGRAM SERVICE REVENUE $1029628 ROUNDING $-1286
Part XI, Line 4bPart XI, Line 4b: Other revenue amounts included on 990 but not included in F/SMEDICAL STAFF INCOME $502978 FOUNDATION DONATION $124865 OTHER EXPENSE $7035 GAIN / LOSS OF SALE OF ASSETS $-258090 PROGRAM SERVICE REVENUE $1029628 FOUNDATION CAPITAL CONTRIBUTION $35021 IN KIND DONATION $8863 ROUNDING $-566
Part V, Line 4Part V, Line 4: Intended uses of the endowment fund.Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Salmon Creek Hospital Foundation (SCHF) maintains all charitable gifts including endowment funds for the benefit of LSCH and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8762535TotalCommunityBenefitExpense
Net Community Benefit Expense8762535NetCommunityBenefitExpense
Percent Of Total Expense0.04060PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense42890263TotalCommunityBenefitExpense
Direct Offsetting Revenue21974794DirectOffsettingRevenue
Net Community Benefit Expense20915469NetCommunityBenefitExpense
Percent Of Total Expense0.09690PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense51652798TotalCommunityBenefitExpense
Direct Offsetting Revenue21974794DirectOffsettingRevenue
Net Community Benefit Expense29678004NetCommunityBenefitExpense
Percent Of Total Expense0.13750PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense54653TotalCommunityBenefitExpense
Net Community Benefit Expense54653NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense629400TotalCommunityBenefitExpense
Net Community Benefit Expense629400NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense240134TotalCommunityBenefitExpense
Net Community Benefit Expense240134NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense924187TotalCommunityBenefitExpense
Net Community Benefit Expense924187NetCommunityBenefitExpense
Percent Of Total Expense0.00430PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense52576985TotalCommunityBenefitExpense
Direct Offsetting Revenue21974794DirectOffsettingRevenue
Net Community Benefit Expense30602191NetCommunityBenefitExpense
Percent Of Total Expense0.14180PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$15,137,732BadDebtExpenseAmount
Amount Attributable To10445035AmountAttributableTo
Amount Reimbursed By Medicare34192987AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare42916707CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8723720MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1LEGACY SALMON CREEK HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12211 NE 139TH STREETAddressLine1
CityVANCOUVERCity
StateWAState
ZIP Code98686ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.legacyhealth.orgWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1LEGACY SALMON CREEK HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted11NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
Other Needs AddressedXOtherNeedsAddressed
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
File Form4720 Report Excise TaxfalseFileForm4720ReportExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Affilated Health Care System Roles and PromotionLSCH is a subsidiary of Legacy Health (Legacy). Legacy is an integrated health system based in Portland, Oregon and primarily operates five acute care hospitals and related services (e.g., physician practices, hospice, preferred provider network) in the four county metro area of Portland and SW Washington. The Legacy Board is comprised of community and business leaders as well as representatives of the medical staff. The LSCH medical staff is open, with physicians submitting credentialing information reviewed according to LSCH policies and standards. In 1998, the Legacy Board approved a $10 million Community Health Fund from operating revenue to address major community health issues. About $500,000 annually has been granted to community-based projects addressing racial and ethnic inequities and root causes. These dollars are in addition to the system's generous charitable contributions. The Community Health Fund has provided over 35 grants since 1998 totaling nearly $6.7 million. In 2010, Legacy established the Health Literacy initiative. The ability of patients to both understand and act upon the medical information provided to them is critical to their health outcomes. Patients must use information to navigate the health system (complete insurance and government forms, sign consents, schedule appointments), manage diseases and acquire preventive screenings. Providers (defined as all staff interacting with or developing materials used by patients) are responsible for ensuring that patients can act on the information provided. Funded by the Community Health Fund in 2012, Legacy hosted the first Oregon and SW Washington Health Literacy Conference. 360 people from 69 organizations attended. In 2013, the Health Literacy Conference had 500 health professionals attend and ensuring this conference as an annual event. Legacy is now the recognized leader in moving health literacy forward both in the health delivery system and broader community.Recognizing that education, employment and income inequities exist for communities of diversity, and that health professions are lacking in diversity, Legacy established the Youth Employment in Summer program in 1999. Annually, 13-15 African American, Hispanic and Native American youth receive paid summer employment in departments where they work with health professionals and earn college scholarships between $2,500 and $5,000 annually. Students must remain in school and pursued health careers in order to continue in the program. Some students remain in the program as long as seven years and graduated with degrees in a variety of healthcare fields. The vast majority of the students are the first in the families to go to college. In addition to the Community Health Fund, Legacy provided cash donations to local health and human service, education, economic development and civic organizations. Donations focus on organizations with year-round relationships through programs and board representation. A few examples include the Free Clinic of SW Washington, Children's Center, Columbia River Mental Health, Community Services Northwest, Clark County Health Department and the local schools.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeNon-cash donations of resources include clinical and non-clinical services and items such as screenings and support services, internships, information and referral services and health fairs. Legacy's warehouse is located on Legacy Good Samaritan's campus and is open to nonprofit organizations to obtain surplus equipment and furniture. In addition, conference room space is made available to local nonprofits for Board and community meetings.Clinical staff at Legacy hospitals are involved with local communities through many child safety programs. In 1986, nurses in Emanuel Hospital's Level I Trauma Center developed the Trauma Nurses Talk Tough (TNTT) program. Taught by trauma and emergency medical professionals, the program reaches 56,000 people each year. The American Hospital Association awarded the TNTT program its NOVA Award. In addition, Legacy staff members conduct free education sessions to show parents how to properly install car seats. Last year, Legacy staff fit and sold more than 11,000 bicycle and snow helmets for children at a nominal or no fee based on need. Legacy staff members also provide new parents with training to reduce the incidences of shaken baby syndrome and our in-house Safety Store sells child protection devices for the home at a nominal charge.
Part VI - Community InformationLSCH opened in 2005 in north Clark County between the cities of Vancouver to the south and Battle Ground and Ridgefield to the north in an unincorporated area known as Salmon Creek and Hazel Dell. The primary service area is defined as the five mile radius, but due to the hospital's location in an unincorporated area and since there are only two hospitals in the county, the county is the commonly used primary service area composition. This definition extends from the Columbia River on the south, north to La Center, west to Vancouver Lake and east to Camas. The primary service area includes the cities of Vancouver, Battle Ground, Ridgefield and Camas. Vancouver and Camas are industrial, commercial and residential communities while and Battle Ground and Ridgefield are primarily residential. Zip codes for the primary service area include: 98601, 98603, 98604, 98606-07, 98616, 98622, 98629, 98642, 98660-68, 98671, 98674-75 and 98682-87.In November 2010, the Portland State University (PSU) Population Research Center reported the metro Portland area four-county population at 2,080,926. This includes Oregon tri-county and Clark county populations. It is estimated that if the economic recovery continues to be slow, population growth will continue at a similar rate, leading to a four-county metro area population of 2.2 million in 2015.The population of the five mile primary service area was 161,987 in 2010. During the 1990s, Clark County was the fastest growing county in Washington. Since 2000 the population grew 20 percent to 436,391 in 2010. Of the four metro area counties, Clark is expected to show the greatest growth between 2010 and 2015 at 1.9 percent annually. Out of all cities in Washington, Vancouver grew 13%, the most during the last decade. Nearly half of newcomers move to the area from California and many others relocate from Oregon.About 38 percent of the county population lives in Vancouver and 9 percent lives in the unincorporated north. There are seven cities in the county, the largest being Vancouver (the fourth largest city in Washington), followed in order by Camas, Battle Ground, Washougal, Ridgefield, La Center and Yacolt. Population density initially was focused on the southern half of the county and then migrated to the east into Camas and even Washougal. As Camas housing prices have increased, the most rapid growth has shifted to the northern cities of Ridgefield, Battle Ground, La Center and Yacolt.The population is slightly younger than the state. The median age in Clark County is 35 years as compared to Washington at 37 years. 23.5% of Washington's population is 18 years and younger, while that of Clark County is 26.5%.In 2010 the LSCH primary service area was 81.8% non-Hispanic white, 7.6% Hispanic, 2.0% African American, 4.1% Asian, 4.0% bi-racial and 0.9% Native American. It is commonly recognized that communities of color may be undercounted in census numbers. Hispanics are moving into the LSCH service area at a higher rate than any other group (more than doubling in numbers in the past 10 years). Additionally, they have a higher birth rate than other communities of color. The Hispanic population accounts for about one-fifth of the births in Washington, while they make up just 11% of the population. While still a small population relative to the entire metro area, specific geographic areas are experiencing significant growth in the Slavic population, particularly in Clark County. Slavs are counted in the non-Hispanic white population, but they have distinct cultural identity. Their socioeconomic indicators are generally lower than the other non-Hispanic white populations.Peace Health SW Washington Medical Center is the only other hospital that serves the LSCH primary service area. Kaiser Permanente has multiple clinics in the county and contracts with Peace Health for services. The service area includes a Medically Underserved Areas (MUA) in central Vancouver. There is also one non-public sector Federally Qualified Health Center (FQHC) operated by SeaMar and one long-standing volunteer-based safety net Free Clinic in Vancouver. The Clark County Health Department does not operate primary care services directly. A local non-profit, Project Access Clark County, links uninsured low income individuals to no-cost healthcare services. All of the health systems in the metro area are very involved with this program. Legacy Health provides cash donations, free administrative office space for Project Access NOW on the Legacy Good Samaritan Medical Center campus as well as clinical services. In FY 13, LSCH provided $8.8 million in charity care; total unreimbursed costs of care for people in need amounted to $40.5 million.
Part VI - Patient Education of Eligibility for AssistanceLSCH employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, LSCH's financial assistance program, and public assistance programs, such as Medicaid. The criteria for financial assistance under LSCH's program is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for medically necessary services provided. Specifically, the LSCH Financial Assistance Program provides an uninsured discount of 15% to patients who have resided within LSCH's primary service area for a period of six months, are uninsured for hospital care, and have a household income of less than $100,000 annually. Further discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level or roughly $92,200 for a family of four in Portland, Oregon. For patients whose household income is at or below 200% of the federal poverty level, a full subsidy is available. In addition to the household income criteria, the patients' qualified assets (e.g. 25% of household assets), and other catastrophic or economic circumstances are considered in determining eligibility. In addition to financial counselors and social workers, LSCH makes every effort to communicate its Financial Assistance Program to patients. This includes signage in main admitting areas of each hospital and brochures explaining financial assistance in all patient care areas, as well as in appropriate languages. Financial counselors are available to assist patients in understanding and applying for available resources, including the LSCH Financial Assistance Program. LSCH's website also has information about the availability of financial assistance. LSCH offers financial assistance customer service Monday through Friday, as well as the availability of voice mail so patients can leave confidential, detailed messages during non-business hours. Finally all of Legacy's billing statements include information regarding the availability of financial assistance. If LSCH requires the use of a collection agency, those agencies are required to provide a telephone number that patients can call to request financial assistance.In 2010, Legacy Health established the Health Literacy initiative. Nearly all Legacy employees are touch points to patients and families and health literacy is involved in every touch point. What is health literacy? The Institute of Medicine defines health literacy as the capacity to obtain, understand, and process basic health information and services needed to make appropriate health decisions. In short, health literacy is the ability to understand and act on health information. Nearly half of the U.S. adult population has a low level of health literacy. Patients with low health literacy are less likely to comply with treatment, less likely to seek preventive care and twice as likely to be hospitalized. Quality, safety and cost are all affected by a patient's inability to understand medical instructions and to explain their symptoms/issuesLegacy's employees are learning and practicing new way of communicating with patients using health literacy tools such as universal precautions, plain language and teach back methods. Annual education is provided to all billing and admitting staff so they can be kept informed of and speak with knowledge about current financial assistance policies and options. LSCH provides copies of the latest policies in main admitting areas, as well as through newsletters and other publications. Since 2008, the four county metro area health delivery systems (encompassing all hospitals in the area) and safety net clinics have partnered to establish a seamless, coordinated program to provide care for the low income uninsured, Project Access. This program enables low income uninsured patients to receive continuity of care in earlier stages of acuity due to the collaboration among 2800 providers and all health systems.
Part VI - Needs AssessmentSenior leadership, in conjunction with the Board of Directors, continually assesses the needs of the communities it serves through a compilation of primary and secondary market research (qualitative and quantitative), medical staff input, reviewing national trends and practices, working with local foundations and funders regarding their assessments, and working with local community-based partners to understand their needs. The goal is to understand the needs and develop programs specific to the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of these assessments is the development of both long-term and fiscal year plans that are supported by a yearly budget that is proposed by staff and approved by the Board of Directors. During 2010, Legacy Health conducted a community needs assessment. The results of the assessment were available in July of 2011 and can be found at www.LegacyHealth.org. The region served by Legacy Salmon Creek Hospital (LSCH), along with most of Washington, is experiencing significant challenges in population growth, economic development, education and health care. Recognizing that social and economic determinants impact health, LSCH has been and will remain committed to addressing these issues to improve the health of all residents in the community, including equity among ethnically diverse populations.
Part V, Line 20d - Other Billing Determination of Individuals Without InsuranceThe hospital facility used the Federal Poverty Guidelines to determine the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care. Discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level. A full subsidy is available for patients whose income is at or below 200% of the federal poverty level.Number of Hospital Faciltiy - 1
Part V, Line 7 - Explanation of Needs Not Addressed and Reasons WhyLegacy Salmon Creek did not address needs identified in the Community Needs Assessment for the reasons explained in the following, by need. These are included in the Community Needs Assessment and Implementation Strategies Plan.NEED: Early Childhood: limited financial and labor resources prevent addressing as need.NEED: HIV/AIDS: limited financial and labor resources prevent addressing as need.NEED: Autism: limited financial and labor resources prevent addressing as need.Number of Hospital Faciltiy - 1
Part V, Line 6i - Describe Other Needs IdentifiedThe action plan for Legacy Salmon Creek can be found at www.legacyhealth.org.Using these criteria and the lens of racial and ethnic equity in response to the evident disparities for communities of color, a Legacy Salmon Creek Medical Center Implementation Strategies Plan details strategies in order of priority of need. All needs expressed by stakeholders related to health, health care and public health are listed, including those not addressed by Legacy Salmon Creek as a focus priority due to lack of resources. Many needs beyond the five focus areas are addressed within hospital services and activities and these can be found in the Plan. Legacy Salmon Creeks resources and strengths are in health-related services and, thus, the five focus areas are health-related needs and actions. Community stakeholders clearly stressed recommending focused attention in contrast to a broader superficial approach in addressing issues.Based on the criteria, Legacy Salmon Creek will focus on:Communities of color, charity care, access to health care, health literacy and youth and education.Number of Hospital Faciltiy - 1
Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs AssessmentThe Community Needs Assessment was conducted in conjunction with the four other Legacy Health hospitals, i.e., Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center and Legacy Mount Hood Medical Center.Number of Hospital Faciltiy - 1
Part V, Line 3 - Account Input from Person Who Represent the CommunityIn July of 2011, the results of Legacy's community needs assessment were available and can be found at www.Legacyhealth.org.Input from persons who represent the community consisted of one on one personal interviews conducted by leadership with elected officials (state, county and city) and public sector (public health, human services), faith, business and community nonprofit organization members, including representatives of culturally, racially and ethnically diverse and low income communities. Interviewees were intentionally designated based on their direct involvement with organizations and/or issues in the service areas. The following lists 28 interviewees, by title and organization.Thomas D. Aschenbrener, President/CEO, Northwest Health FoundationSharon Brabenac, Development Director, YWCA of Greater PortlandSam Brooks, Former President, Oregon Association of Minority EntrepreneursMarie Dahlstrom, Director, Familias en AccionJohn Deeder, Superintendent, Evergreen School DistrictChris DeMars, Program Officer, NW Health FoundationHal Dengerink, PhD, President, Washington State University VancouverKevin Dowling, Program Manager,CARES NWJeana Frazzini, Executive Director, Basic Rights Oregon Guadalupe Guajardo, Senior Consultant, Nonprofit Association of Oregon Bob Knight, President, Clark CollegeCara Larson, Family Educator, Children's Home SocietyMarc Levy, Executive Director, United Way of the Columbia WillametteAdrienne Livingston, Executive Director, Black United FundCharles McGee II, President/CEO, Black Parent InitiativeRichard Melching, President, Community FoundationVicki Nakashima, Executive Director, Partners in DiversityLinda Nilsen-Solares, Executive Director, Project Access NOWNancy Parker, Executive Director, Columbia River Mental HealthSharon Pesut, Executive Director, Community ChoicesKelly Sills, Director of Comm. Development, Clark CountyLynn Thompson, CEO, Big Brothers Big Sisters Columbia NorthwestGreg Van Pelt, Chief Executive Oregon, Providence Health and Services Carrie Vanzant, Clinic Manager,SeaMar Health CenterSteven Webb, EdD., Superintendent, Vancouver School DistrictBarbe West, Executive Director, Free Clinic of SW WashingtonJoyce White, Executive Director, Grantmakers of OR and SW WAJohn Wiesman, Director,Clark County Health Depart.Number of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsLegacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $63,070,202 and $73,212,836 respectively. This results in a total Medicare shortfall of $10,142,635.Costing Methodology (Part III, Line 8).Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay.
Part III, Line 4 - Bad Debt ExpenseThe footnote that describes the Legacy bad debt expense can be found on page 14 of the attached audited financial statements.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitThe estimated amount of bad debt expenses attributable to charity care policy was calculated using the demographic profile of household income and average household size in the zip code areas around the hospital. 69% of Households in the LSCH service area would qualify for financial assistance with incomes under 400% of the Federal Poverty Guidelines using this methodology.
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseLSCH uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, LSCH must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgstrueCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptiontrueInitialContractException
Rebuttable Presumption ProceduretrueRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
TRENT S GREEN
SR VP3252885915438780451943064449906040454
TIMOTHY J RODDY
PHYSICIAN191316246434-29543095927920493675
TERESA L HANDY
VP REVENUE CYCLE OPERATIONS167144118628361646426142222448
SONJA O STEVES
SR VP2997465257236341716392421048450835749
PAMELA VUKOVICH
FORMER SR. VP & TREAS2305117394912247316707
P CAMPBELL GRONER III
SR VP & SEC353473688211125638950740776665140106177
MAUREEN A BRADLEY
SR VP2350015346851691956819731332937
LOW L LEWIS
SR. VP. CHIEF MEDICAL OFFICER3331813917681026369312619951651316213
LIAN R SHAW
PHYSICIAN425037355224642801210892484105
LANI GASKILL
NURSE EXECUTIVE111762137053436201191917621498627
JONATHAN E AVERY
VP3100636766248327567562739051019837664
JOHN J KENAGY
SR VP2746191000051332360715662329021
JOHN G BUCKMASTER
PHYSICIAN33812918936156491855631254422524
GLEN C LUTZ
SR VP2007412228642833734150377
GEORGE J BROWN MD
President & CEO917307255586277557333283481021831835250411
GEORGE A CIOFFI MD
SR VP45789309808604684773420838222257
FRED H COLEMAN
PHYSICIAN3381291893633672190337738417508
EVERETT NEWCOMB III
SR VP5543921209631620215404832389877994
DAVID E EAGER
CFO & TREAS54001011590057523021229584721458
CAROL A BRADLEY
SR VP3237305821147538473663388451072939685

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationSch J, Part 1, Question 3 Regarding Compensation PracticesDirectors for Legacy are not compensated, but receive expense reimbursements related to their duties. Any expense reimbursements to board members are reviewed by the Director of Tax for determining 1099 tax reporting. During 2012, Corliss McKeever was reimbursed for Board Educational travel. A guest attended with Ms. McKeever. Any reimbursed expense related to spouse or guest travel is reported on part VII of the form 990. Compensation received by Dr. Newberry during 2012 related to his responsibilities as Past President of the Medical Staff at Legacy Meridian Park Hospital. Dr. Root received compensation relating to her duties as President of the Legacy Emanuel Medical Staff & compensation for medical services provided to Legacy Emanuel Hospital.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for executive positions. The Committee oversees the system's governance procedures with respect to intermediate sanctions legislation and the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Sch J, Part II, Column Breakdown Of W-2 Or Misc-1099:Column B(i) - Base compensation consists of regular base pay including employee elected deferrals for retirement plans (403(b) and 457(b) plans).Column B(ii) - The incentive compensation program for Legacy is based on predetermined criteria and reviewed and approved by the Board. Bonuses are paid to key employees for interim duties outside their primary responsibilities (e.g. Acting in Capacity).Column B(iii) - Other compensation consists of deferred compensation amounts paid to executives during the current year and were reported on prior form 990 returns. These amounts include arrangements that contain elements of a substantial risk of forfeiture conditioned on continued employment, vesting and/or a noncompete provision upon termination of employment. In addition, imputed income for insurance, cell phone and other benefits is included in other compensation as well as any severance related payments. Column C - Deferred compensation includes the value of defined benefit plans, contributions to defined contribution plans, amounts deferred under the 457(f) plan including earnings, earnings in the 457(b) plan, and the value of the pension restoration plan. Earnings on the 457(f) and 457(b) include gains and losses on the underlying investments. The defined contribution and benefit plans are available to all employees as they become qualified to participate. The pension restoration plan provides executive pension benefits in excess of IRS mandated limits on eligible compensation to key executives. The benefits are unfunded and subject to forfeiture. Executive pension benefits are intended to make the executive's retirement benefit, as a proportion of their final average salary, comparable to all other employees, and are treated as income when paid.The Legacy Health Board approved an Executive Long Term Incentive Plan effective April 1, 2011 for 3 years ending on March 31, 2014. The initial participants include the CEO, CFO and COO. The Plan is discretionary and can be terminated at any time. The purpose of the Plan is to attract and retain highly qualified senior executives, to focus management performance and reward participants for contributing to the accomplishments of Legacys long-term objectives. The long-term strategic goals include improving the quality of care by preventing serious adverse events by ensuring a culture of safety for employee; growth and strategy by achieving meaningful use and optimal care outcomes; and financial management with improved bond rating and increased philanthropic support for programs. Targets for operating margins are required over the three year period and all goals are measured at March 31, 2014. Payout is after approval from the Legacy Health Compensation committee and the Legacy Health Board. Although the Plan is not funded and is subject to substantial risk of forfeiture, Part II, Schedule J, column C reporting is required as deferred compensation for FY2013. Included in the CEO and COOs deferred compensation amount for the Plan is $177,864, and $76,333 respectively. The CFO left Legacy in 2013 and is not eligible to receive any payout. Column D - Nontaxable benefits include company paid health and welfare and long term care and disability benefits under group plans.Column F - Current year compensation reported as deferred in prior years.
Sch J, Part I, Line 8Part I, Line 8: Amounts reported on 990 VII pursuant to initial contract exemption described in RegsLegacy enters into initial employment agreements with executives that qualify under the initial contract exception. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee relies on comparable market data and all decisions are documented.
Sch J, Part I, Line 6bPart I, Line 6b: Explanation of organization compensation contingent on net earnings from related orLegacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets.
Sch J, Part I, Line 5bPart I, Line 5b: Explanation of organization compensation based on revenues of related organizationPhysicians employed by Legacy affiliates are paid a bonus contingent upon their revenue generated during the year measured by industry standard relative value units (RVU).

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonJOHN G BUCKMASTERNamePerson
Purpose Of LoanMalpracticePurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$64,780OriginalPrincipalAmount
Balance Due17502BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due17502TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Schedule JSchedule J Reporting of Officers and Senior Management on Legacy Affilate Returns. The Legacy Officers, Senior Vice Presidents and other key employees may have responsibilities for the operations of the entire health system, including the affiliated entities. Their compensation is paid from and reported on the Legacy return(EIN 23-7426300). The compensation is reported again for informational purposes on related affiliated entity returns including, Legacy Emanuel Hospital & Health Center, Legacy Good Samaritan Hospital and Medical Center, Legacy Meridian Park Hospital, Legacy Mount Hood Medical Center, Legacy Salmon Creek Hospital, Legacy Visiting Nurse Association, and Legacy Adventist Venture.
Form 990, Part XLSCH participates in the Legacy investment pooled funds which include professionally managed equity and fixed income securities in both separately managed portfolios and commingled investment accounts. Investment returns are prorated according to each affiliate's share of the pool.
Form 990, Part VI, question 2Legacy Health System CPC, LLC (CPC) is a common pay agent for Legacy and its affiliates. The CPC files all required federal employment tax returns for Legacy and its affiliates. The number of employees reported on Form W-3 for LSCH is 1897.
Form 990, Part IV, question 12Legacy has an audit of its consolidated financial statement which includes consolidating schedules highlighting LSCH's financial results.
Other Changes In Net Assets Or Fund Balances - Other DecreasesRounding = -$6Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other DecreasesIN KIND DONATION = -$8863Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other DecreasesADDITIONAL MINIMUM PENSION LIABILITY = -$4097061Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableLegacy Health's audited and interim consolidated financial statements are publicly available on the Electronic Municipal Market Access(EMMA) (www.emma.msrb.org) and DAC Bond (www.dacbond.com) websites. Legacy's audited consolidated financial statements include consolidating schedules which highlights LSCH's financial results.When changes are made to the LSCH Articles or Bylaws, LSCH discloses and attaches copies to the IRS Form 990, which are publicly available by request or on various public websites such as Guidestar(www.guidestar.org). Other governing documents are not available to the public.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe following describes the compensation practices of Legacy and its affiliates.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee oversees the system's governance procedures with respect to the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe following is a summary of Legacy's policy and procedures for conflict of interest disclosure, monitoring and resolution.All Legacy employees and non-employees in leadership positions (e.g., Board members, Foundation Trustees, Medical Directors) are required to disclose potential conflicts of interest as the conflict arises. All employees are required to disclose any conflict of interest per the Standard of Conduct policy. Certain groups have annual formal disclosure requirements, Executives and non-employees in leadership positions complete the Conflict Disclosure Statement from the Standards of Conduct policy annually. Officers, Directors, Trustees, Key and Highly Compensated employees are also required to complete a questionnaire covering business relationships, business transactions with interested parties, loans and grants. Conflict Disclosure Statements and questionnaires are returned to Legacy Corporate Compliance or Tax Departments for review of the disclosure. If a conflict is disclosed, or identified through any other means, Legacy Corporate Compliance ensures that management mitigates the risk (e.g., discontinues relationship with vendor, segregates responsibilities, recuses Board member from voting in area of conflict) and that the conflict and mitigation steps are reported to the appropriate level (e.g., Compliance Committee, Audit Committee of the Board).Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe Legacy Board received a copy of the 990 return prior to filing. At the direction of the entire Board, the Board Compensation Committee reviewed the compensation disclosures and the Board Audit Committee reviewed the 990 returns for Legacy and Legacy Emanuel Hospital & Health Center with Management prior to filing. Any key differences in disclosure for other affiliated entities, including Legacy Salmon Creek Hospital were discussed with the Board Audit Committee.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersThe appointed persons by the Oregon Synod Council and the Convention of the Episcopal Diocese may not be removed from the Board without written consent of their respective organizations.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyThe Board of Directors includes the following members: (a) The Bishop of the Oregon Synod of the Evangelical Lutheran Church inAmerica (the "Oregon Synod") or the Bishop's designee, who shall serve ex officio;(b) The Bishop of the Episcopal Diocese of Oregon (the "Episcopal Diocese")or the Bishop's designee, who shall serve ex officio;(c) One (1) person appointed by election of the Oregon Synod Council;(d) One (1) person appointed by election of the Convention of the EpiscopalDiocese.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderLegacy Health is the sole member of Legacy Salmon Creek Hospital.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
LEGACY ADVENTIST VENTURE
1919 NW LOVEJOY STPORTLANDOR97209931121816HEALTHCAREOR501(C)(3)9N/Afalse
SALMON CREEK HOSPITAL FOUNDATION
PO BOX 4484PORTLANDOR97208830433165CHARITABLE FOUNDATIONWA501(C)(3)7N/Atrue
MT HOOD MEDICAL CENTER FOUNDATION
PO BOX 4484PORTLANDOR97208930794951CHARITABLE FOUNDATIONOR501(C)(3)11aN/Afalse
MERIDIAN PARK MEDICAL FOUNDATION
PO BOX 4484PORTLANDOR97208930773410CHARITABLE FOUNDATIONOR501(C)(3)11aN/Afalse
GOOD SAMARITAN FOUNDATION
PO BOX 4484PORTLANDOR97208237017276CHARITABLE FOUNDATIONOR501(C)(3)11aN/Afalse
THE CHILDRENS HOSPITAL FOUNDATION
PO BOX 4484PORTLANDOR97208931314469CHARITABLE FOUNDATIONOR501(C)(3)7N/Afalse
EMANUEL MEDICAL CENTER FOUNDATION
PO BOX 4484PORTLANDOR97208936095667CHARITABLE FOUNDATIONOR501(C)(3)7N/Afalse
LEGACY VISITING NURSE ASSOCIATION
815 NE DAVIS STPORTLANDOR97210930848530HOSPICEOR501(C)(3)9N/Afalse
LEGACY MOUNT HOOD MEDICAL CENTER
24800 SE STARK STGRESHAMOR97030930591528HOSPITALOR501(C)(3)3N/Afalse
LEGACY MERIDIAN PARK HOSPITAL
19300 SW 65TH AVETUALATINOR97062930618975HOSPITALOR501(C)(3)3N/Afalse
LEGACY GOOD SAMARITAN HOSPITAL & MEDICAL
1015 NW 22ND AVEPORTLANDOR97210930386793HOSPITALOR501(C)(3)3N/Afalse
LEGACY EMANUEL HOSPITAL & HEALTH CENTER
2801 N GANTENBEIN AVEPORTLANDOR97227930386823HOSPITALOR501(C)(3)3N/Afalse
LEGACY HEALTH
1919 NW LOVEJOY STPORTLANDOR97209237426300HEALTHCAREOR501(C)(3)11bN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SALMON CREEK HOSPITAL FOUNDATION
m109252Actual Cost
SALMON CREEK HOSPITAL FOUNDATION
c124865Cash

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.