2014-02-18T15:46:11-08:00 2013-03-31 990 2012-04-01 331065485 LEGACY SALMON CREEK HOSPITAL LEGA 5034155600 2211 NE 139TH STREET VANCOUVER WA 98686 LINDA S HOFF 2014-02-18 2012 2015-11-30 17:44:51Z GEORGE J BROWN MD C/O 1919 NW LOVEJOY STREET PORTLAND OR 97209 228884853 false false X WWW.LEGACYHEALTH.ORG X 2002 WA Legacy Salmon Creek Hospital (LSCH), established in 2005, provides acute and critical care in Vancouver, with 165 licensed beds. LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and 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 a 15 14 0 875 485997 -22951 30247 168749 217539807 223060480 1968268 4520993 -1160515 -1180488 218377807 226569734 4372 4372 0 121724075 128201299 0 0 86650471 87555236 208378918 215760907 9998889 10808827 278259891 289012354 34989594 39039160 243270297 249973194 Legacy Salmon Creek Hospital (LSCH), established in 2005, provides acute and critical care in Vancouver, with 165 licensed beds. LSCH operates adult, pediatric, and OB/GYN hospitalist programs, as well as four primary care physician practices and 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 a false false 154729038 4372 207947126 LSCH was the State of Washington's first new hospital construction since 1979. The hospital opened in August 2005 with 165 licensed beds, all of which are single occupancy. LSCH provides a full array of hospital services, including surgery, diagnostics, inpatient and outpatient medical services, neonatal intensive care unit, pediatric, obstetrical, and emergency services. LSCH utilizes an electronic information system for medical records and physician order entry. Physicians are able to complete their entire patient records electronically and can remotely access patient records, including diagnostic images.In support of its mission, LSCH voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. During fiscal year 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.. 17426966 15113354 LSCH 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. 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BUCKMASTER 40.00 0.00 X 372714 0 49810 LANI GASKILL 40.00 0.00 X 469087 0 29540 TIMOTHY J RODDY 40.00 0.00 X 434796 0 58879 LIAN R SHAW 40.00 0.00 X 465201 0 18904 PAMELA VUKOVICH 0.00 0.00 X 0 230511 86196 2738429 6375086 1622646 165 true true false THE VANCOUVER CLINIC INC 700 NE 87TH AVE VANCOUVER WA 98664 MEDICAL SERVICES 705650 MEDLINE INDUSTRIES PO BOX 121080 DEPT 1080 DALLAS TX 75312 MEDICAL SUPPLIES 3744863 GE MEDICAL SYSTEMS PO BOX 843553 DALLAS TX 75284 MEDICAL EQUIPMENT 1268445 ELEKTA INC PO BOX 404199 ATLANTA GA 30384 MEDICAL SERVICES 571850 COLUMBIA ANESTHESIA GROUP PO BOX 5157 VANCOUVER WA 98668 MEDICAL SERVICES 505380 26 168749 8863 168749 RETAIL PHARMACY 485997 485997 PATIENT PROGRAM REV 530017613 530017613 CONVENIENCE OF MEMBERS 1533967 1533967 CONTRACTUAL ALLOWANCE -285166762 -285166762 CHARITY CARE -23810335 -23810335 223060480 4779083 4779083 0 0 1134631 2315119 -1180488 -1180488 -1180488 -258090 -258090 -258090 -258090 0 0 0 0 226569734 220782426 485997 5132562 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X 127249 163605 127249 163605 187471913 1186791417 187599162 1186955022 1000000 1000000 250000 250000 false 2000000 2000000 2000000 2000000 8000000 12000000 263925 349418 288019 290854 1192216 500000 500000 500000 500000 2000000 3000000 275304 392109 267 148370 519310 195066 107966 27728 275304 136521 90600 -32055 259176 58038 152877 74394 136521 8321 86833 37116 58038 0.59000 0.41000 false true true 10173635 10173635 241094037 78058645 163035392 30958 9907 21051 84368882 63761195 20607687 1158374 1158374 194996139 63195838 NONCURRENT WORKERS' COMP LIABILITY 322000 NONCURRENT PENSION LIABILITY 23027297 COMPANY AFFILIATE PAYABLE 17502 23366799 225120000 225120000 1449734 1449734 226569734 214420000 214420000 1340907 1340907 215760907 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S MEDICAL 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 4b Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S MEDICAL 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 4 Part V, Line 4: Intended uses of the endowment fund. Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Salmon Creek Hospital Foundation (SCHF) maintains all charitable gifts including endowment funds for the benefit of LSCH and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator. true true X true X true X true true true false true true 8762535 8762535 0.04060 42890263 21974794 20915469 0.09690 51652798 21974794 29678004 0.13750 54653 54653 0.00030 629400 629400 0.00290 240134 240134 0.00110 924187 924187 0.00430 52576985 21974794 30602191 0.14180 false 15137732 10445035 34192987 42916707 -8723720 X true true 1 1 LEGACY SALMON CREEK HOSPITAL

2211 NE 139TH STREET VANCOUVER WA 98686

www.legacyhealth.org X X X LEGACY SALMON CREEK HOSPITAL 1 true X X X X X X X X X 11 true true true X X X X X X X X X X false false false true true 200.0000 true 400.0000 true X X X X X X X true true X X X X X X true false X X X X true X false false Part VI - Affilated Health Care System Roles and Promotion LSCH is a subsidiary of Legacy Health (Legacy). Legacy is an integrated health system based in Portland, Oregon and primarily operates 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 Purpose Non-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 Information LSCH opened in 2005 in north Clark County between the cities of Vancouver to the south and Battle Ground and Ridgefield to the north in an unincorporated area known as Salmon Creek and Hazel Dell. The primary service area is defined as the five mile radius, but due to the hospital's location in an unincorporated area and since there are only two hospitals in the county, the county is the commonly used primary service area composition. This definition extends from the Columbia River on the south, north to La Center, west to Vancouver Lake and east to Camas. The primary service area 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 Assistance LSCH employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, LSCH's financial assistance program, and public assistance programs, such as Medicaid. The criteria for financial assistance under LSCH's program is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for medically necessary services provided. Specifically, the LSCH Financial Assistance Program provides an uninsured discount of 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 Assessment Senior leadership, in conjunction with the Board of Directors, continually assesses the needs of the communities it serves through a compilation of primary and secondary market research (qualitative and quantitative), medical staff input, reviewing national trends and practices, working with local foundations and funders regarding their assessments, and working with local community-based partners to understand their needs. The goal is to understand the needs and develop programs specific to the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of these assessments is the development of both long-term and fiscal year plans that are supported by a yearly budget that is proposed by staff and approved by the Board of Directors. 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. Number of Hospital Faciltiy - 1 Part V, Line 20d - Other Billing Determination of Individuals Without Insurance The 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 Why Legacy Salmon Creek did not address needs identified in the Community Needs Assessment for the reasons explained in the following, by need. These are included in the Community Needs Assessment and Implementation Strategies Plan.NEED: Early Childhood: limited financial and labor resources prevent addressing as need.NEED: HIV/AIDS: limited financial and labor resources prevent addressing as need.NEED: Autism: limited financial and labor resources prevent addressing as need. Number of Hospital Faciltiy - 1 Part V, Line 6i - Describe Other Needs Identified The 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 Assessment The 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 Community In 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. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Legacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $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 Expense The 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 Benefit The estimated amount of bad debt expenses attributable to charity care policy was calculated using the demographic profile of household income and average household size in the zip code areas around the hospital. 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 Expense LSCH uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, LSCH must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information. true true false true true true true false true true TRENT S GREEN 325288 59154 38780 45194 30644 499060 40454 TIMOTHY J RODDY 191316 246434 -2954 30959 27920 493675 TERESA L HANDY 167144 11862 836 16464 26142 222448 SONJA O STEVES 299746 52572 36341 71639 24210 484508 35749 PAMELA VUKOVICH 230511 73949 12247 316707 P CAMPBELL GRONER III 353473 68821 112563 89507 40776 665140 106177 MAUREEN A BRADLEY 235001 53468 5169 19568 19731 332937 LOW L LEWIS 333181 39176 81026 36931 26199 516513 16213 LIAN R SHAW 425037 35522 4642 8012 10892 484105 LANI GASKILL 111762 13705 343620 11919 17621 498627 JONATHAN E AVERY 310063 67662 48327 56756 27390 510198 37664 JOHN J KENAGY 274619 10000 5133 23607 15662 329021 JOHN G BUCKMASTER 338129 18936 15649 18556 31254 422524 GLEN C LUTZ 20074 122286 4283 3734 150377 GEORGE J BROWN MD 917307 255586 277557 333283 48102 1831835 250411 GEORGE A CIOFFI MD 45789 309808 60468 4773 420838 222257 FRED H COLEMAN 338129 18936 33672 19033 7738 417508 EVERETT NEWCOMB III 554392 120963 16202 154048 32389 877994 DAVID E EAGER 540010 115900 5752 30212 29584 721458 CAROL A BRADLEY 323730 58211 47538 47366 33884 510729 39685 Sch J, Part III, Additional Information Part III, Additional Information Sch 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 8 Part I, Line 8: Amounts reported on 990 VII pursuant to initial contract exemption described in Regs Legacy enters into initial employment agreements with executives that qualify under the initial contract exception. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee relies on comparable market data and all decisions are documented. Sch J, Part I, Line 6b Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or Legacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets. Sch J, Part I, Line 5b Part I, Line 5b: Explanation of organization compensation based on revenues of related organization Physicians employed by Legacy affiliates are paid a bonus contingent upon their revenue generated during the year measured by industry standard relative value units (RVU). JOHN G BUCKMASTER Malpractice X 64780 17502 false true true 17502 Form 990, Schedule J Schedule J Reporting of Officers and Senior Management on Legacy Affilate Returns. The Legacy Officers, Senior Vice Presidents and other key employees may have responsibilities for the operations of the entire health system, including the affiliated entities. Their compensation is paid from and reported on the Legacy return(EIN 23-7426300). The compensation is reported again for informational purposes on related affiliated entity returns including, Legacy Emanuel Hospital & Health Center, Legacy Good Samaritan Hospital and Medical Center, Legacy Meridian Park Hospital, Legacy Mount Hood Medical Center, Legacy Salmon Creek Hospital, Legacy Visiting Nurse Association, and Legacy Adventist Venture. Form 990, Part X LSCH participates in the Legacy investment pooled funds which include professionally managed equity and fixed income securities in both separately managed portfolios and commingled investment accounts. Investment returns are prorated according to each affiliate's share of the pool. Form 990, Part VI, question 2 Legacy Health System CPC, LLC (CPC) is a common pay agent for Legacy and its affiliates. The CPC files all required federal employment tax returns for Legacy and its affiliates. The number of employees reported on Form W-3 for LSCH is 1897. Form 990, Part IV, question 12 Legacy has an audit of its consolidated financial statement which includes consolidating schedules highlighting LSCH's financial results. Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases Rounding = -$6 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases IN KIND DONATION = -$8863 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases ADDITIONAL MINIMUM PENSION LIABILITY = -$4097061 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Legacy Health's audited and interim consolidated financial statements are publicly available on the Electronic Municipal Market Access(EMMA) (www.emma.msrb.org) and DAC Bond (www.dacbond.com) websites. Legacy's audited consolidated financial statements include consolidating schedules which highlights LSCH's financial results.When changes are made to the LSCH Articles or Bylaws, LSCH discloses and attaches copies to the IRS Form 990, which are publicly available by request or on various public websites such as Guidestar(www.guidestar.org). Other governing documents are not available to the public. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The following describes the compensation practices of Legacy and its affiliates.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee oversees the system's governance procedures with respect to the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The following is a summary of Legacy's policy and procedures for conflict of interest disclosure, monitoring and resolution.All Legacy employees and non-employees in leadership positions (e.g., Board members, Foundation Trustees, Medical Directors) are required to disclose potential conflicts of interest as the conflict arises. All employees are required to disclose any conflict of interest per the Standard of Conduct policy. Certain groups have annual formal disclosure requirements, Executives and non-employees in leadership positions complete the Conflict Disclosure Statement from the Standards of Conduct policy annually. Officers, Directors, Trustees, Key and Highly Compensated employees are also required to complete a questionnaire covering business relationships, business transactions with interested parties, loans and grants. Conflict Disclosure Statements and questionnaires are returned to Legacy Corporate Compliance or Tax Departments for review of the disclosure. If a conflict is disclosed, or identified through any other means, Legacy Corporate Compliance ensures that management mitigates the risk (e.g., discontinues relationship with vendor, segregates responsibilities, recuses Board member from voting in area of conflict) and that the conflict and mitigation steps are reported to the appropriate level (e.g., Compliance Committee, Audit Committee of the Board). Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process The Legacy Board received a copy of the 990 return prior to filing. At the direction of the entire Board, the Board Compensation Committee reviewed the compensation disclosures and the Board Audit Committee 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 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The appointed persons by the Oregon Synod Council and the Convention of the Episcopal Diocese may not be removed from the Board without written consent of their respective organizations. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors includes the following members: (a) The Bishop of the Oregon Synod of the Evangelical Lutheran Church inAmerica (the "Oregon Synod") or the Bishop's designee, who shall serve ex officio;(b) The Bishop of the Episcopal Diocese of Oregon (the "Episcopal Diocese")or the Bishop's designee, who shall serve ex officio;(c) One (1) person appointed by election of the Oregon Synod Council;(d) One (1) person appointed by election of the Convention of the EpiscopalDiocese. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Legacy Health is the sole member of Legacy Salmon Creek Hospital. LEGACY ADVENTIST VENTURE 1919 NW LOVEJOY ST PORTLAND OR 97209 931121816 HEALTHCARE OR 501(C)(3) 9 N/A false SALMON CREEK HOSPITAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 830433165 CHARITABLE FOUNDATION WA 501(C)(3) 7 N/A true MT HOOD MEDICAL CENTER FOUNDATION PO BOX 4484 PORTLAND OR 97208 930794951 CHARITABLE FOUNDATION OR 501(C)(3) 11a N/A false MERIDIAN PARK MEDICAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 930773410 CHARITABLE FOUNDATION OR 501(C)(3) 11a N/A false GOOD SAMARITAN FOUNDATION PO BOX 4484 PORTLAND OR 97208 237017276 CHARITABLE FOUNDATION OR 501(C)(3) 11a N/A false THE CHILDRENS HOSPITAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 931314469 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false EMANUEL MEDICAL CENTER FOUNDATION PO BOX 4484 PORTLAND OR 97208 936095667 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false LEGACY VISITING NURSE ASSOCIATION 815 NE DAVIS ST PORTLAND OR 97210 930848530 HOSPICE OR 501(C)(3) 9 N/A false LEGACY MOUNT HOOD MEDICAL CENTER 24800 SE STARK ST GRESHAM OR 97030 930591528 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY MERIDIAN PARK HOSPITAL 19300 SW 65TH AVE TUALATIN OR 97062 930618975 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY GOOD SAMARITAN HOSPITAL & MEDICAL 1015 NW 22ND AVE PORTLAND OR 97210 930386793 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY EMANUEL HOSPITAL & HEALTH CENTER 2801 N GANTENBEIN AVE PORTLAND OR 97227 930386823 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY HEALTH 1919 NW LOVEJOY ST PORTLAND OR 97209 237426300 HEALTHCARE OR 501(C)(3) 11b N/A false false true true false false false false false false false true false true false false false false false false SALMON CREEK HOSPITAL FOUNDATION m 109252 Actual Cost SALMON CREEK HOSPITAL FOUNDATION c 124865 Cash