2014-08-15T16:02:42-05:00 2013-09-30 910189318 MOSS ADAMS LLP 805 SW BROADWAY STE 1200 PORTLAND OR 97205 990 2012-10-01 930508781 SKY LAKES MEDICAL CENTER SKYL 5412746311 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 RICHARD RICO 5412746311 2014-08-14 1 WENDY CAMPOS P00448102 5032421447 2012 2015-11-30 17:44:51Z PAUL STEWART 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 448750541 0 X WWW.SKYLAKES.ORG X 1979 OR SKY LAKES MEDICAL CENTER WILL CONTINUALLY STRIVE TO REDUCE THE BURDEN OF ILLNESS, INJURY AND DISABILITY, AND TO IMPROVE THE HEALTH, SELF- RELIANCE AND WELL-BEING OF THE PEOPLE WE SERVE. WE WILL DEMONSTRATE THAT WE ARE COMPETENT AND CARING IN ALL WE DO. WE SHALL ENDEAVOR TO BE SO SUCCESSFUL IN THIS EFFORT THAT WE WILL BECOME A PREEMINENT HEALTHCARE CENTER. 9 8 1344 359 7352 3390 519427 2108577 390702910 443177926 1585916 2891059 94687 -239830 392902940 447937732 224181 252388 0 0 78196204 83990919 0 0 0 296902508 348624683 375322893 432867990 17580047 15069742 194957124 216824030 69739902 76047401 125217222 140776629 X SKY LAKES MEDICAL CENTER WILL CONTINUALLY STRIVE TO REDUCE THE BURDEN OF ILLNESS, INJURY AND DISABILITY, AND TO IMPROVE THE HEALTH, SELF- RELIANCE AND WELL-BEING OF THE PEOPLE WE SERVE. WE WILL DEMONSTRATE THAT WE ARE COMPETENT AND CARING IN ALL WE DO. WE SHALL ENDEAVOR TO BE SO SUCCESSFUL IN THIS EFFORT THAT WE WILL BECOME A PREEMINENT HEALTHCARE CENTER. 0 0 372330650 26774 438377350 PATIENT CARE EXPENSES - ACUTE INPATIENT CARE FOR ADULT AND PEDIATRIC PATIENTS; A LEVEL III TRAUMA EMERGENCY DEPARTMENT; SERVICES RELATED TO CHILD ABUSE, HOME CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES; A CANCER TREATMENT CENTER WITH BOTH MEDICAL AND RADIATION ONCOLOGY; AND DIAGNOSTIC TESTING (LABORATORY AND DIAGNOSTIC IMAGING) AVAILABILITY IN SETTINGS AROUND THE COMMUNITY. 29892158 UNCOMPENSATED CARE - DURING FISCAL YEAR 2013, SKY LAKES MEDICAL CENTER CONTINUED TO SEE AN INCREASE IN CHARITY CARE APPLICATIONS AND WRITE OFFS FOR BAD DEBT. BY WAY OF COMPARISON, THE ECONOMY IN KLAMATH COUNTY IS POORER THAN THE STATE OF OREGON, INCLUDING HIGHER UNEMPLOYMENT RATES AND MEDICAL INDIGENCY. CHARGES WRITTEN OFF UNDER OUR BROAD REACHING CHARITY CARE POLICY TOTALED $15,764,015. CHARGES WRITTEN OFF AS BAD DEBT TOTALED $14,128,143. AS A PERCENTAGE OF CHARGES, THESE REPRESENT 4.1% AND 3.2% RESPECITVELY. THE AVERAGE CHARITY CARE WRITE OFFS BACK TO 2004 RAN 2.8%. WE ARE DOING A MUCH BETTER JOB OF IDENTIFYING PATIENTS REQUIRING CHARITY CARE AT THE TIME SERVICE IS PROVIDED AND AVOIDING, AS MUCH AS POSSIBLE, HAVING SERVICES LATER CHARGED OFF AS BAD DEBT. THIS IS PUSHING UP OUR CHARITY CARE WRITE OFFS AND BRINGING DOWN OUR BAD DEBT WRITE OFFS. 5177705 149899 1755080 EDUCATIONAL SUPPORT - SKY LAKES MEDICAL CENTER COMMITS SIGNIFICANT DOLLARS AND MAN-HOURS TO BENEFIT EDUCATIONAL EFFORTS IN AND FOR THE COMMUNITY. AMONG THOSE COMMITMENTS ARE THE FOLLOWING: OREGON HEALTH & SCIENCE UNIVERSITY AFFILIATED FAMILY PRACTICE RESIDENCY PROGRAM AND CLINIC; AN RN I TRAINING PROGRAM TO INCLUDE 6 MONTHS OF ONE-ON-ONE SUPERVISED ORIENTATION TO THE INPATIENT CARE AREAS; AWARDING OF SCHOLARSHIPS TO COMMUNITY MEMBERS AND/OR EMPLOYEES IN HEALTHCARE- RELATED PROGRAMS; A HOSPITAL DEPARTMENT, LEARNING RESOURCES, DEDICATED TO THE EDUCATION OF PHYSICIANS, EMPLOYEES AND COMMUNITY MEMBERS; COMMITMENT TO EMPLOYEES ACTING, EITHER FULL-TIME OR PART-TIME, AS INSTRUCTORS IN ACCREDITED COURSES AT THE HIGH SCHOOL, COMMUNITY COLLEGE OR UNIVERSITY LEVEL; STIPEND PAYMENTS TO STUDENTS PERFORMING WORK AND/OR ON-THE-JOB TRAINING WITHIN THE HOSPITAL SETTING; TUITION REIMBURSEMENTS PAID TO EMPLOYEES ENROLLED IN COLLEGE-LEVEL COURSEWORK; JOINT PARTICIPATION IN A SIMULATION LABORATORY WITH OIT; FREE OR MINIMAL COST COMMUNITY EDUCATIONAL OPPORTUNITIES SUCH AS DIABETES EDUCATION, NUTRITION AND OTHER EDUCATION PROGRAMS IN OR FOR THE SCHOOLS; AND HEALTH FAIRS. 75715 75715 3115435 EXPENSES RELATED TO MEDICAL CENTER SUPPORTING SERVICES SUCH AS ADMINISTRATION, INFORMATION SYSTEMS, FINANCIAL SERVICES, REVENUE CYCLE PROCESSES, HUMAN RESOURCES, ENGINEERING, ENVIRONMENTAL SERVICES, RISK MANAGEMENT, AND SAFETY AND SECURITY. 75715 75715 3115435 407476228 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 203 0 1 1344 1 1 1 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 0 OR X RICHARD RICO VPCFO 5412746150 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 JOHN BELL 3.00 1.00 X X 0 0 0 ROD WENDT 1.00 1.00 X X 0 0 0 PAUL R STEWART 50.00 1.00 X X 530703 0 26888 KERMIT HOUSER 1.00 1.00 X 0 0 0 CLARK PEDERSON 1.00 3.00 X 0 0 0 BERNARD SIMONSON 1.00 1.00 X 0 0 0 WENDY WARREN MD 1.00 1.00 X 0 0 0 DOUGLAS MCINNIS DVM 1.00 1.00 X 0 0 0 JOHN R PATTE MD 10.00 1.00 X 22550 0 0 GRANT NISKANEN MD 40.00 1.00 X 188718 0 7356 RICHARD RICO 50.00 X 358926 0 32096 PATRICK MAVEETY MD 40.00 X 450572 0 21224 STANTON T SMITH MD 40.00 X 420333 0 31844 RICHARD DEVORE MD 40.00 X 340858 0 30860 JAYMIE PANUNCIALMAN MD 40.00 X 271669 0 32039 W CLAY MCCORD MD 40.00 X 233014 0 24960 2817343 0 207267 74 0 1 0 KLAMATH ORTHOPEDIC CLINIC 2220 BRYANT WILLIAMS DRIVE KLAMATH FALLS OR 97601 PHYSICIAN PRACTICE 1209061 EBMS 2075 OVERLAND AVENUE BILLINGS MT 59102 BENEFIT PLAN ADMIN 682893 MODOC CONTRACTING COMPANY INC 409 PINE STREET KLAMATH FALLS OR 97601 CONSTRUCTION CONTRACTING 667161 WEATHERBY LOCUMS INC 6451 NORTH FEDERAL HIGHWAY SUITE 8 FORT LAUDERDALE FL 33308 STAFFING SERVICES 619717 LINDE HEALTHCARE STAFFING PO BOX 915241 DALLAS TX 753915241 STAFFING SERVICES 514206 20 2108577 2108577 PATIENT REVENUE 621990 438377350 438377350 OTHER PROGRAM REVENUE 621990 4800576 4800576 443177926 2900065 2900065 700809 696231 4578 4578 4578 70 9076 -9006 -9006 -9006 121394 107502 13892 13892 PASSTHROUGH INCOME 621990 77291 69939 7352 OTHER INCOME 900099 -335591 -335591 -258300 447937732 443247865 7352 2573938 75715 75715 176673 176673 1146100 77539 1068561 65342344 60505061 4837283 2597994 2262235 335759 9778650 8928050 850600 5125831 4136050 989781 200148 7186 192962 159213 640 158573 7910450 7103057 807393 771848 280495 491353 1971073 1207459 763614 2689197 60729 2628468 3224822 3122358 102464 157063 116778 40285 529535 447937 81598 2925239 12006 2913233 8826235 3049835 5776400 1939887 825714 1114173 CONTRACTUAL ALLOWANCE 240886726 240886726 SUPPLIES 25572088 25439414 132674 CHARITY CARE 15764015 15764015 TAXES PAID ON UBI 1200 1200 35095944 32990556 2105388 432867990 407476228 25391762 0 92098 10740249 29636460 24067447 23811862 21815609 0 150313 2234783 1814623 2793011 2416059 186489536 97645966 85334626 88843570 28172899 37089769 3196520 3712125 19684865 26174266 194957124 216824030 7093782 6166803 2574744 2541306 50102082 55834010 1093445 1014735 8875849 10490547 69739902 76047401 X 125217222 140776629 125217222 140776629 194957124 216824030 X 15069742 497111 -7446 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13956740 12716 2126606 10509 1214051 281672 14589830 11698651 20361 2760201 12270 220861 289342 13956740 12339426 98175 -202310 32407 256108 248125 11698651 11694819 86864 1209992 37029 390645 224575 12339426 14291129 164841 -2183225 10388 341106 226432 11694819 1.00000 0.00000 0.00000 0 1 1 1882451 1882451 114277095 52473028 61804067 4298719 2536442 1762277 48102006 34554704 13547302 17929265 8081792 9847473 88843570 ASSETS LIMITED AS TO USE 9485540 OTHER ASSETS 1526526 RISK POOL WITHHOLD RECEIVABLE 1883658 DEFERRED FINANCING COSTS 1776101 CONSTRUCTION IN PROCESS 4502724 OTHER RECEIVABLES 6999717 26174266 CAPITAL LEASE OBLIGATIONS 6773237 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 3717310 10490547 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENTS ARE HELD BY A RELATED ORGANIZATION, SKY LAKES MEDICAL CENTER FOUNDATION, FOR THE BENEFIT OF SKY LAKES MEDICAL CENTER. THE CONTINUED GROWTH OF THE ENDOWMENT FUNDS ALLOWS FOR LARGER EXPENDITURES OF INVESTMENT AND OTHER INCOME TO BE SPENT WITHOUT EXPENDING ANY OF THE INITIAL GIFTED FUNDS OR DESIGNATED FUNDS, WHICH REMAIN AS ENDOWED FUNDS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: FIN 48 (ASC 740) FOOTNOTE - THE MEDICAL CENTER HAD NO UNRECOGNIZED TAX BENEFITS AT SEPTEMBER 30, 2013 OR 2012. THE MEDICAL CENTER RECOGNIZES INTEREST ACCRUED AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS AN ADMINISTRATIVE EXPENSE. DURING THE YEARS ENDED SEPTEMBER 30, 2013 AND 2012, THE MEDICAL CENTER RECOGNIZED NO INTEREST AND PENALTIES. THE MEDICAL CENTER FILES AN EXEMPT ORGANIZATION INFORMATION AND AN UNRELATED BUSINESS INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION AND AN UNRELATED BUSINESS INCOME TAX RETURN WITH THE OREGON DEPARTMENT OF REVENUE. 1 1 X 1 X 1 X 1 1 1 0 1 1 12536 12859735 12859735 0.03070 30401970 30347469 54501 0.00010 12536 43261705 30347469 12914236 0.03080 12 46899 247267 2352 244915 0.00060 2 5 4149876 1755080 2394796 0.00570 5 244041 25510013 18652208 6857805 0.01640 144823 144823 0.00030 19 290945 30051979 20409640 9642339 0.02300 19 303481 73313684 50757109 22556575 0.05380 9 231143 654874 483773 171101 0.00040 1 1660 16240 0 16240 0.00000 1 4800 1020 0 1020 0.00000 12 107303 174340 0 174340 0.00040 3 100030 760484 0 760484 0.00180 26 444936 1606958 483773 1123185 0.00260 0 14128143 2684347 45723823 48138478 -2414655 X 1 1 1 1 SKY LAKES MEDICAL CENTER

2865 DAGGETT AVENUE KLAMATH FALLS OR 97601

WWW.SKYLAKES.ORG X X X X SKY LAKES MEDICAL CENTER 1 1 X X X X X X X X X 12 1 0 1 X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X X X X 1 0 X X X X X 1 X 0 1 14 OUTPATIENT IMAGING

2900 DAGGETT AVENUE KLAMATH FALLS OR 97601

OUTPATIENT DIAGNOSTIC IMAGING CENTER CANCER TREATMENT CENTER

2610 URHMANN ROAD KLAMATH FALLS OR 97601

MEDICAL CLINIC FAMILY MEDICINE RESIDENCY

2801 DAGGETT AVENUE KLAMATH FALLS OR 97601

MEDICAL CLINIC & MEDICAL RESIDENCY PROGRAM MAIN - FAMILY PRACTICE CLINIC

1905 MAIN KLAMATH FALLS OR 97601

MEDICAL CLINIC MEDICAL OFFICE BUILDING I

2200 BRYANT WILLIAMS DRIVE KLAMATH FALLS OR 97601

MEDICAL CLINIC CENTER FOR OCCUPATIONAL HEALTH

2621 CROSBY AVENUE KLAMATH FALLS OR 97603

REHABILITATION SERVICES, HOME HEALTH SERVICES, EMPLOYEE ASSISTANCE PROGRAM MEDICAL OFFICE BUILDING II

3000 BRYANT WILLIAMS DRIVE KLAMATH FALLS OR 97601

MEDICAL CLINIC SANFORD - INTERNALFAMILY MED CLINICS

3001 DAGGETT AVENUE KLAMATH FALLS OR 97601

MEDICAL CLINIC ALMOND - ENT CLINIC

2617 ALMOND STREET KLAMATH FALLS OR 97601

MEDICAL CLINIC CLAIRMONT GASTRO & PULMO CLINICS

2301 2303 CLAIRMONT DRIVE KLAMATH FALLS OR 97601

MEDICAL CLINIC UROLOGY CLINIC

2630 CAMPUS DRIVE KLAMATH FALLS OR 97601

MEDICAL CLINIC MEDICAL OFFICE BUILDING III

2680 URHMANN ROAD KLAMATH FALLS OR 97601

MEDICAL CLINIC COMMUNITY HEALTHEDUCATION

2200 NORTH ELDORADO AVENUE KLAMATH FALLS OR 97601

COMMUNITY EDUCATION FACILITY HUGH CURRIN HOUSE

2601 DAGGETT AVENUE KLAMATH FALLS OR 97601

RESIDENTIAL FACILITY FOR FAMILIES UNDERGOING CARE PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED FOR THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS TABLE. THE RATIO WAS DERIVED USING WORKSHEET 2, 'RATIO OF PATIENT CARE COST-TO-CHARGES.' PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 14128143. PART II: COMMUNITY BUILDING ACTIVITIES:COMMUNITY SUPPORT: ACTIVITIES INCLUDE KLAMATH-LAKE CHILD ABUSE RESPONSE AND EVALUATION SERVICES (CARES). CARES IS DEDICATED TO PROVIDING SAFE, COMPREHENSIVE, OBJECTIVE MEDICAL ASSESSMENTS, AND TO RAISING AWARENESS ABOUT CHILD ABUSE THROUGH COORDINATED, COLLABORATIVE EDUCATIONAL PROGRAMS. FOUR TIMES PER YEAR, DISCOUNTED AND FREE PRESCRIPTION DRUGS, ALONG WITH EDUCATIONAL SUPPORT BY LICENSED PHARMACISTS, ARE PROVIDED TO LOW INCOME ELDERLY THROUGH LOCAL SENIOR CENTERS. THE NO ONE DIES ALONE PROGRAM IS A VOLUNTEER PROGRAM THAT PROVIDES THE REASSURING PRESENCE OF A VOLUNTEER COMPANION TO DYING PATIENTS WHO WOULD OTHERWISE BE ALONE. SKY LAKES ALSO PARTICIPATES IN RELAY FOR LIFE, UNITED WAY AND OTHER LOCAL FUNDRAISING AND AWARENESS INITIATIVES, AS WELL AS ONGOING EFFORTS IN THE PERIOD OF PURPLE CRYING COMMUNITY EDUCATION CAMPAIGN. THERE ARE A NUMBER OF OTHER COMMUNITY SUPPORT ACTIVITIES THAT ARE PROVIDED, INCLUDING BUT NOT LIMITED TO SPONSORSHIP OF SUPPORT GROUPS FOR CANCER, ADOPTING FAMILIES AT CHRISTMAS, TRANSPORTATION ASSISTANCE TO INDIGENT PATIENTS, STAFF VOLUNTEER PARTICIPATION IN COMMUNITY EVENTS, AND FREE ACCESS TO MEETING ROOMS.LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: SKY LAKES AND SKY LAKES EMPLOYEES WORK IN CONJUNCTION WITH THE KLAMATH COUNTY HIGH SCHOOLS AND OREGON INSTITUTE OF TECHNOLOGY TO DEVELOP AN AWARENESS OF HEALTH CARE, HEALTH CARE CAREERS, AND SUPPORT FOR HEALTH PROFESSIONS EDUCATION SUPPORT AND TRAINING. SENIORS IN THE OREGON HEALTH & SCIENCE UNIVERSITY NURSING PROGRAM IN KLAMATH FALLS CONDUCT QUALITATIVE SURVEILLANCE OF THE PERCEIVED HEALTH STATUS OF PEOPLE IN NEARBY COMMUNITIES AND REPORT ON BARRIERS TO ACCESS TO HEALTHCARE IDENTIFIED BY THOSE COMMUNITIES. THE STUDENTS USE TOOLS INCLUDING ONE-ON-ONE INTERVIEWS, FOCUS GROUPS, PUBLIC MEETINGS, AND PHONE SURVEYS. THEIR DATA ARE SHARED WITH COMMUNITY LEADERS AND COMPARED WITH OTHER DATA TO DEVELOP COMPREHENSIVE IMPROVEMENT STRATEGIES.COALITION BUILDING: THE LOCAL HEALTH DEPARTMENT, IN CONJUNCTION WITH THE OREGON HEALTH DEPARTMENT, PERIODICALLY PERFORMS HEALTH ASSESSMENTS OF THE PEOPLE IN THE COMMUNITIES SERVED BY SKY LAKES. THE MEDICAL CENTER WORKS WITH LOCAL HEALTH AUTHORITIES TO DETERMINE THE HEALTH INITIATIVES THAT CAN BE JOINTLY ADDRESSED BY COMMUNITY LEADERS, WITH SKY LAKES MEDICAL CENTER SERVING A SIGNIFICANT LEADERSHIP ROLE. SKY LAKES MEDICAL CENTER ACTIVELY PARTNERS WITH AGENCIES SUCH AS THE KLAMATH COUNTY HEALTH DEPARTMENT, OREGON HEALTH & SCIENCE UNIVERSITY, AND THE UNITED WAY OF THE KLAMATH BASIN IN HEALTH-IMPROVEMENT INITIATIVES. EMPLOYEES VOLUNTEER THEIR TIME FOR LEADERSHIP KLAMATH, KLAMATH HOSPICE AND MANY OTHER COMMUNITY SERVICE ORGANIZATIONS WHERE LEADERS COME TOGETHER.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: SKY LAKES ALSO SUPPORTS COMMUNITY HEALTH IMPROVEMENT ADVOCACY VIA THE SOUTHERN OREGON METH PROJECT. SOMP IS MADE UP OF COMMUNITY BUSINESSES THAT HOPE TO HAVE AN IMPACT ON THE 75% OF CHILDREN IN FOSTER CARE THAT ARE THERE BECAUSE OF METH AND ON THE 8 OUT OF 10 ARRESTS BEING RELATED TO METH. OVERWHELMED COURTS AND JAILS IN OUR COMMUNITY HELP DRIVE THE SOMP PARTNERS TO COME TOGETHER TO STOP THE NEXT GENERATION FROM WORSENING THE PROBLEM. OTHER HEALTH IMPROVEMENT ADVOCACY TAKES PLACE VIA AN ANNUAL HEALTH FAIR AND ONGOING EDUCATIONAL OFFERINGS FOR HEART DISEASE, CHOLESTEROL SCREENING, WEIGHT MANAGEMENT, NUTRITION, DUII, EATING ON A BUDGET, BREASTFEEDING, SMOKING CESSATION, CAR SEAT SAFETY, AIDS/HIV, AND DIABETES. IN ADDITION TO COMMUNITY MEMBERS, EDUCATIONAL OFFERINGS INCLUDE NURSING STUDENTS, ELEMENTARY, MIDDLE, HIGH SCHOOLS AND LOCAL COLLEGES. EMPLOYEE SUPPORT - TIME AND MONETARY DONATIONS - OF LOCAL FOOD BANKS IS ALSO ENCOURAGED.WORKFORCE DEVELOPMENT: SKY LAKES UNDERWRITES THE WAGES AND BENEFITS OF SELECTED NEW GRADUATES FROM THE LOCAL BACCALAUREATE NURSING PROGRAM. THESE NURSES SPEND 6 MONTHS ORIENTING TO VARIOUS INPATIENT UNITS BY SHADOWING EXPERIENCED REGISTERED NURSES IN ORDER TO DETERMINE THE BEST EMPLOYMENT "FIT" FOR THEM AND FOR SKY LAKES. PART III, LINE 4: BAD DEBTS ARE ACCRUED MONTHLY AT A FIXED PERCENTAGE OF GROSS CHARGES. BOOKED BAD DEBT EXPENSE IS ROUTINELY COMPARED TO ACTUAL BAD DEBT WRITEOFFS, WHICH INCLUDE PAYMENTS TO PREVIOUSLY RECORDED BAD DEBTS, AND THE ACCRUAL PERCENTAGE IS ADJUSTED ACCORDINGLY. THIS PROCESS HAS THE INTENDED EFFECT OF REALIZING BAD DEBT EACH MONTH AS A LESS VOLATILE EXPENSE.BAD DEBT EXPENSE INCLUDES PAYMENTS - PATIENT AND INSURANCE - TO PREVIOUSLY RECORDED BAD DEBTS.SKY LAKES MEDICAL CENTER OFFERS A CHARITY CARE APPLICATION TO ALL PATIENTS, EITHER IN PERSON OR MAKING IT AVAILABLE VIA US MAIL OR ON THE HOSPITAL'S WEBSITE. A SAMPLE OF PROCESSED CHARITY CARE APPLICATIONS WAS TAKEN. WE FOUND THAT 19% OF CHARITY CARE APPLICATIONS WERE TURNED TO BAD DEBT DUE TO LACK OF INFORMATION SUPPLIED BY THE HOUSEHOLD. WE ASSUME THAT ALL REMAINING BAD DEBT ACCOUNTS WERE CORRECTLY CLASSIFIED DURING OUR COLLECTION PROCESS. THIS 19% REPRESENTS $2.7 MILLION.THE FOOTNOTE THAT DISCUSSES BAD DEBT EXPENSE IS CONTAINED ON PAGE 11 OF THE ATTACHED FINANCIAL STATEMENTS, ENTITLED 'PATIENT ACCOUNTS RECEIVABLE.' PART III, LINE 8: MEDICARE REIMBURSEMENTS DO NOT COVER THE COSTS OF DELIVERING CARE TO THE COMMUNITY. IN ADDITION, SKY LAKES IS A TEACHING HOSPITAL THAT PROVIDES ACCESS TO PRIMARY CARE IN A RURAL COMMUNITY THAT HAS A PHYSICIAN SHORTAGE.SERVICES PROVIDED AND PAID ON THE MEDICARE FEE SCHEDULE (E.G. OUTPATIENT LAB TESTS, OUTPATIENT THERAPY SERVICES, OR PROVIDER BASED PHYSICIAN SERVICES) ARE NOT INCLUDED IN THE MEDICARE AMOUNTS INCLUDED IN PART III, SECTION B.SKY LAKES DOES NOT UTILIZE A COST ACCOUNTING SYSTEM. VENDORS AND SURVEYING AGENCIES (GOVERNMENTAL AND NON-GOVERNMENTAL) ARE PROVIDED WITH THE MEDICARE COST REPORT COST-TO-CHARGE RATIO WHEN THEY REQUEST IT.COSTS OF ROUTINE AND ICU NURSING SERVICES ARE CALCULATED ON A PER DIEM. ANCILLARY SERVICE COSTS ARE CALCULATED BASED ON TOTAL COSTS INCLUDING OVERHEAD TO TOTAL CHARGES BY ANCILLARY SERVICE TO DEVELOP A RATIO OF COSTS-TO-CHARGES (RCC), WITH MEDICARE'S APPORTIONMENT CALCULATED BY TAKING MEDICARE CHARGES MULTIPLIED BY THE RCC DEVELOPED ON THE COST REPORT. PART III, LINE 9B: SKY LAKES PLACES ALL ACCOUNTS IDENTIFIED AS ELIGIBLE FOR FINANCIAL ASSISTANCE ON HOLD AND THEN MAKES ANY NECESSARY ADJUSTMENTS BEFORE STATEMENTS ARE SENT. MANY OF THESE ACCOUNTS ARE ADJUSTED OFF COMPLETELY AND NO STATEMENTS ARE SENT. SKY LAKES ALSO CALLS PAST DUE ACCOUNTS (THIRD STATEMENT) AND REVIEWS TO SEE IF FINANCIAL ASSISTANCE IS AVAILABLE. LARGER ACCOUNTS ARE REVIEWED BY FINANCIAL COUNSELORS AND CHAMBERLIN EDMONDS FOR FINANCIAL ASSISTANCE ELIGIBILITY OR MEDICAID ELIGIBILITY. BOTH GROUPS MAKE PROACTIVE CALLS AND FOLLOW UP WITH PATIENTS TO GET THE NECESSARY INFORMATION TURNED IN. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 1J: WHAT BEGAN AS A CONVERSATION BETWEEN THE COMMUNITY HEALTH OUTREACH MANAGER AT SKY LAKES MEDICAL CENTER, KLAMATH FALLS, ORE., AND THE HEALTH PROMOTION/DISEASE PREVENTION COORDINATOR AT KLAMATH COUNTY (ORE.) PUBLIC HEALTH BECAME THE SEED THAT TOOK ROOT AND THEN FLOURISHED INTO A MAJOR COLLABORATION AMONG LOCAL PUBLIC AND PRIVATE PARTNERS.THE COLLABORATION - COMMUNITY PARTNERS SEEKING BETTER HEALTH -- EVOLVED INTO HEALTHY KLAMATH, A SEMI-FORMAL ORGANIZATION REPRESENTING A WIDE VARIETY OF PUBLIC-SECTOR AGENCIES AND DEPARTMENTS AS WELL AS PRIVATE PARTIES WITH INFLUENCE IN LOCAL HEALTH. IT HAS AT ITS CORE THE MEDICAL CENTER, THE LOCAL HEALTH DEPARTMENT, A MANAGED-CARE ORGANIZATION FOR THE MEDICAID POPULATION, AND A FEDERALLY QUALIFIED HEALTHCARE PRACTICE WITH TWO FAMILY PRACTICE CLINICS IN THE COUNTY. KLAMATH FALLS CITY AND KLAMATY COUNTY GOVERNMENT, STATE OF OREGON AGENCIES, AND MEMBERS OF LOCAL SCHOOL DISTRICTS AND HIGHER EDUCATION ARE ALSO REPRESENTED.FURTHER THE PARTNERSHIP ALSO INCLUDES A LOCAL RURAL RESIDENCY PROGRAM, OREGON STATE UNIVERSITY'S EXTENSION IN KLAMATH COUNTY, OREGON HEALTH & SCIENCES UNIVERSITY'S NURSING PROGRAM AT OREGON INSTITUTE OF TECHNOLOGY, THE LOCAL NEWSPAPER AND THE REGION'S LARGEST RADIO STATION. THE ASSESSMENT LAUNCHED AS A RESULT OF SKY LAKES LEADERSHIP RECOGNIZING THERE ARE MYRIAD CAUSES FOR POOR HEALTH AND THE PROBLEM IS TOO LARGE FOR ANY ONE ORGANIZATION TO TAKE ON ALONE, AND SO WORKED AS A "COMMUNITY CONVENER" TO GET OTHERS TO THE TABLE TO PLAN AND IMPLEMENT CHANGE. THE INTENT WAS TO HEAR FROM MANY VOICES AND TO STRIVE FOR HARMONY AS WE WORKED TOGETHER TO MAKE IMPROVEMENTS THAT WOULD LAST. AT THE SAME TIME, MEDICAL CENTER LEADERS RIGHTLY UNDERSTOOD THERE ARE POTENTIAL SOLUTIONS TO THE PROBLEMS OF POOR HEALTH THAT ARE BEYOND THEIR PURVIEW. THE MEDICAL CENTER TOOK THE LEAD TO HELP FIND WAYS EACH OF THE PARTNERS COULD USE THEIR UNIQUE EXPERTISE TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR SUCCESS IS MONITORED AND MEASURED BY THE HCI INDICATORS.WITHIN TWO MONTHS OF THE INITIAL MEETING, UNDER THE LEADERSHIP OF THE MEDICAL CENTER AND WITH THE FULL COOPERATION OF THE PARTNERS, THE "CORE FOUR" HAD AGREED TO A PLAN TO DEPLOY THE HCI WEB-BASED INDICATORS TOOL (HEALTHKLAMATH.ORG) AND A FRAMEWORK TO ACCOMMODATE THE VARIOUS OTHER COMMUNITY PARTNERS IN THE PROCESS. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COORDINATED BY SKY LAKES MEDICAL CENTER DONE IN KLAMATH COUNTY REPRESENTS THE COLLABORATIVE WORK BETWEEN SKY LAKES MEDICAL CENTER AND ITS LOCAL PARTNERS. THIS CHNA IS THE FIRST OF ITS KIND TO FORMALLY ASSESS AND DOCUMENT THE HEALTH OF OUR COMMUNITY UTILIZING A COORDINATED AND COLLABORATIVE PROCESS. IT IS THE FIRST STEP TO THE ONGOING PROCESS OF COMMUNITY HEALTH IMPROVEMENT. THE COMMUNITY ASSESSMENT IS UPDATED WHENEVER MORE DATA ARE RECEIVED TO POPULATE MORE THAN 100 HEALTH INDICATORS. THE HEALTHY KLAMATH ORGANIZATION MEETS REGULARLY TO EVALUATE DATA AND PROGRESS OF STRATEGIES TO IMPROVE HEALTH ACCORDING TO THE PREVIOUSLY IDENTIFIED PRIORITIES.THE PRIMARY GOAL OF THE CHNA IS TO BETTER UNDERSTAND THE HEALTH OF OUR COMMUNITY AND TO DEVELOP LOCAL STRATEGIES TO ADDRESS OUR COMMUNITY'S SPECIFIC NEEDS AND IDENTIFIED PRIORITY ISSUES. THE CHNA INFORMS THE GROUP AND HELPS SET COMMUNITY PRIORITIES, ESTABLISH BENCHMARKS AND MONITOR TRENDS IN THE HEALTH STATUS OF KLAMATH COUNTY RESIDENTS. THERE IS AN ADDED BENEFIT IN THAT THE IMPROVEMENT EFFORTS EXTENDS TO OTHER REGIONS IN THE CATCHMENT AREA OUTSIDE THE DEFINED COMMUNITY. WE ACKNOWLEDGE THAT THE CHNA IS A LIVING DOCUMENT, ALLOWING US TO SEEK CONTINUOUS IMPROVEMENT AND FURTHER ANALYZE THE DATA AND, ULTIMATELY, IMPROVE THE HEALTH OF OUR COMMUNITY. UNDERSTANDING THAT HEALTH IS A PRODUCT OF MANY CONDITIONS AND FACTORS, AN ADAPTED VERSION OF THE STRATEGIC PLANNING FRAMEWORK DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) IN COOPERATION WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WAS MADE TO CREATE THIS CHNA. THE STRATEGIC PLANNING FRAMEWORK THAT WAS ADAPTED FOR KLAMATH COUNTY IS KNOWN AS MOBILIZING ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). MAPP IS A COMMUNITY-DRIVEN PROCESS THAT RESULTS IN THE IDENTIFICATION OF HEALTH ISSUES AND HEALTH IMPROVEMENT STRATEGIES THROUGH COMMUNITY MEMBER AND STAKEHOLDER ENGAGEMENT. FACILITATED BY PUBLIC HEALTH LEADERS, MAPP IS INTENDED TO IMPROVE THE EFFICIENCY, EFFECTIVENESS, AND PERFORMANCE OF LOCAL HEALTHCARE SYSTEMS; SKY LAKES IS A PRINCIPAL PART OF THAT LOCAL SYSTEM. MAPP ALLOWS FOR AN ENHANCED UNDERSTANDING OF THE INFLUENCES ON COMMUNITY HEALTH THROUGH THE ANALYSIS OF POPULATION-BASED QUANTITATIVE DATA, LOCALLY GATHERED QUALITATIVE DATA, AND THE EXPERTISE OF KEY STAKEHOLDERS. THESE VARIOUS DATA-COLLECTION METHODS ALLOW FOR A BETTER UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CIRCUMSTANCES IN WHICH PEOPLE ARE BORN, RAISED, LIVE, AND WORK, IN ADDITION TO AVAILABLE RESOURCES. THE SOCIAL DETERMINANTS OF HEALTH PROVIDE A LENS THROUGH WHICH TO VIEW DIFFERENT POPULATIONS AND COMMUNITIES AND IDENTIFY CONDITIONS THAT PROMOTE HEALTH, RATHER THAN LIMIT IT. WITH THIS INFORMATION WE CAN COLLECTIVELY BETTER UNDERSTAND THE DRIVERS OF HEALTH OUTCOMES IN KLAMATH COUNTY AND DEVELOP STRATEGIES FOR HEALTH IMPROVEMENT. WHILE THE STANDARD MAPP INCLUDES FOUR ASSESSMENTS (COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, AND THE FORCES OF CHANGE ASSESSMENT), THE LOCAL PARTNERS AS HEALTHY KLAMATH TAILORED MAPP TO BETTER FIT OUR COMMUNITY. THE PARTNERS DECIDED TO COMBINE THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND FORCES OF CHANGE ASSESSMENT INTO A SINGLE ASSESSMENT. THIS SPECIFIC COMBINATION INCREASED EFFICIENCY AND UTILIZES RESOURCES MOST EFFECTIVELY. THE INFORMATION FOR THIS COMBINED ASSESSMENT WAS COLLECTED FROM STAKEHOLDERS WITH THE ABILITY TO SPEAK TO THE CURRENT SYSTEM AS WELL AS THE FUTURE OPPORTUNITIES AND UNCERTAINTIES THAT MAY AFFECT THE CURRENT SYSTEM. COLLECTING AND ANALYZING THE VOLUME OF DATA NECESSARY TO FULLY UNDERSTAND COMMUNITY HEALTH IS TIME- AND RESOURCE-INTENSIVE, HEALTHY KLAMATH PARTNERS COLLABORATIVELY SOUGHT A SOLUTION TO UTILIZE RESOURCES IN THE MOST EFFECTIVE MANNER. THE PARTNERS AGREED TO UTILIZE THE HEALTHY COMMUNITIES INSTITUTE (HCI), WHICH MANAGES AND CONTINUALLY UPDATES A CENTRALIZED PUBLICALLY AVAILABLE WEB-BASED SOURCE OF POPULATION DATA AND COMMUNITY HEALTH INFORMATION.HCI PROVIDES A PLATFORM FOR CONTINUAL MONITORING AND TRACKING ON 100+ INDICATORS SELECTED BY THE COMMUNITY PARTNERS. THESE INDICATORS WERE ASSESSED ON FOUR FACTORS: 1) COMPARISON TO OREGON AND NATIONAL BENCHMARKS2) TRENDS OVER TIME, 3) HEALTH DISPARITIES, AND4) SEVERITY OF HEALTH ISSUE. THE HEALTH INDICATORS SELECTED MET AT LEAST THREE OF THE FOUR CONDITIONS: - KLAMATH COUNTY RATE IS HIGHER THAN THE OREGON STATE AVERAGE AND/OR DOES NOT MEET THE NATIONAL HEALTHY PEOPLE 2020 BENCHMARK; - THE TREND IS WORSENING; - CERTAIN POPULATIONS ARE EXPERIENCING A DISPARITY; OR - LONG-TERM CONSEQUENCE, PREMATURE DEATH, AND/OR HIGH HEALTH-RELATED EXPENDITURES ARE ASSOCIATED. THE FORMULATION OF THE CHNA COORDINATED BY SKY LAKES MEDICAL CENTER WAS STRONGLY INFLUENCED BY INPUT FROM COMMUNITY PARTNERS AND STAKEHOLDERS AS WELL AS INDIVIDUALS IN KLAMATH COUNTY COMMUNITIES. COMMUNITY INVOLVEMENT IS ESSENTIAL TO SUCCESSFUL PUBLIC HEALTH ACTION, AND THE PRIORITY AREAS FOR HEALTH IMPROVEMENT SHOULD REFLECT THE PROBLEMS OF GREATEST CONCERN TO THE LOCAL COMMUNITIES. HEALTHY KLAMATH PARTNERS REGULARLY SEEK COMMUNITY INPUT VIA LISTENING SESSIONS, FOCUS GROUPS, AND SURVEYS. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 3: THE KLAMATH COUNTY CHNA COORDINATED BY SKY LAKES MEDICAL CENTER IN PARTHERSHIP WITH OTHER PUBLIC AGENCIES IN THE COMMUNITY TAKES INTO ACCOUNT AN UNDERSTANDING OF THE ENVIRONMENT WHITHIN WHICH WE OPERATE. UNDERSTANDING THE STRENGTHS AND WEAKNESS OF THE CURRENT LOCAL HEALTHCARE SYSTEM, IN ADDITION TO ANY UPCOMING SOCIAL, POLITICAL, OR ECONOMIC CHANGES THAT COULD AFFECT THE SYSTEM IS INTEGRAL TO DEVELOPING PRIORITY AREAS OF FOCUS. HEALTHCARE REFORM AND THE CURRENT ECONOMIC CLIMATE ARE LARGELY IMPACTING THE LOCAL HEALTHCARE SYSTEM AND THESE STRUCTURAL CHANGES MUST BE ACCOUNTED FOR. THE HEALTHY KLAMATH PARTNERS IDENTIFIED A LIST OF KEY STAKEHOLDERS ORGANIZED BY SECTOR TO INTERVIEW FOR THIS ASSESSMENT. THE ORIGINAL STAKEHOLDERS WERE SELECTED FOR THEIR ORGANIZATIONS INFLUENCE ON COMMUNITY HEALTH AND THEIR ROLE IN THE PUBLIC HEALTH SYSTEM. THE STAKEHOLDERS, IN ADDITION TO SKY LAKES MEDICAL CENTER, INCLUDE KLAMATH COUNTY PUBLIC HEALTH, CASCADE COMPREHENSIVE CARE, CASCADE HEALTH ALLIANCE, KLAMATH OPEN DOOR CLINICS, THE CITY OF KLAMATH FALLS, KLAMATH FALLS PUBLIC SCHOOLS AND KLAMATH COUNTY SCHOOL DISTRICT, KLAMATH COMMUNITY COLLEGE, OREGON INSTITUTE OF TECHNOLOGY, AND APPROXIMATELY 16 OTHER AGENCIES AND ORGANIZATIONS. AS PART OF THE ASSESSMENT, THE PARTNERS CONDUCTED 20 INTERVIEWS WITH MORE THAN 25 LOCAL STAKEHOLDERS.EACH INTERVIEW BEGAN WITH AN EXPLANATION OF THE CHNA USING THE CHNA FRAMEWORK AND WITH A WRITTEN AND VISUAL DEFINITION OF HEALTH. THIS IS THE WRITTEN DEFINITION OF HEALTH USED IN THE INTERVIEWS: HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY (WORLD HEALTH ORGANIZATION). FURTHER, HEALTH IS NOT SIMPLY A STATE FREE FROM DISEASE BUT IS THE CAPACITY OF PEOPLE TO BE RESILIENT AND MANAGE LIFE'S CHALLENGES AND CHANGES (PUBLIC HEALTH ACCREDITATION BOARD).AFTER ANY QUESTIONS REGARDING THE CHNA WERE ANSWERED, THREE INTERVIEW QUESTIONS FOLLOWED:1. HOW DOES YOUR ORGANIZATION CONTRIBUTE TO THE HEALTH OF THE COMMUNITY?2. WHAT DO YOU SEE AS YOUR ORGANIZATIONS ROLE IN THE LOCAL PUBLIC HEALTH SYSTEM?3. WHAT CHALLENGES DO YOU SEE THAT MAY AFFECT YOUR WORK (UPCOMING CHANGES IN LEGISLATION, FUNDING, TECHNOLOGY, NEW COLLABORATIONS, AND THE LIKE)?COMPLETE ANALYSIS OF THOSE INTERVIEWS AND THEIR RECOMMENDATIONS IS IN PROCESS.ALSO, OREGON HEALTH & SCIENCE UNIVERSITY SCHOOL OF NURSING STUDENTS CONDUCTED LISTENING SESSIONS AND FOCUS GROUPS IN SIX OUTLYING COMMUNITIES (MERRIL, MALIN, BONANZA, CHILOQUIN, MIDLAND, AND KENO) IN RURAL KLAMATH COUNTY. INFORMATION FROM THOSE SESSIONS AND INTERVIEWS ARE IN APPENDIX A OF THE CHNA.FURTHER QUALITATIVE ANALYSIS IN THE FORM OF A WEB-BASED SURVEY WAS CONDUCTED BY THE PARTNERS AND SPONSORED BY SKY LAKES MEDICAL CENTER. NEARLY 900 SELF-SELECTED RESPONDENTS TO THAT SURVEY PROVIDED ADDITIONAL COMMUNITY PERSPECTIVE FOR THE CHNA AND WILL BE USEFUL TO DEFINE STRATEGIES AND TACTICS GOING FORWARD. RESULTS FROM THE SURVEY ARE INCLUDED IN THE FULL CHNA REPORT, WHICH IS AVAILABLE UPON REQUEST VIA WEBMASTER@SKYLAKES.ORG. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 5C: BESIDES THE SKY LAKES MEDICAL CENTER WEBSITE (SKYLAKES.ORG), THE CHNA CONDUCTED BY THE HEALTHY KLAMATH PARTNERS AND COORDINATED BY THE MEDICAL CENTER ALSO WILL RESIDE ON THE HEALTHY KLAMATH WEBSITE (HEALTHYKLAMATH.ORG), ON THE KLAMATH COUNTY HEALTH DEPARTMENT WEBSITE, AND WILL BE AVAILABLE IN PRINT FORM AT SKY LAKES MEDICAL CENTER, AT THE HEALTH DEPARTMENT, AT THE LOCAL NEWSPAPER OFFICE (HERALD AND NEWS, 2701 FOOTHILLS ROAD, KLAMATH FALLS, OR), AND AT THE KLAMATH COUNTY LIBRARY. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 7: INFORMATION GATHERED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FACILITATED BY THE COMMUNITY PARTNERS SEEKING BETTER HEALTH AND USING THE HEALTHY KLAMATH INITIATIVE INDICATES A STRATIFICATION OF PRIORITIES.DATA COLLECTED BY VARIOUS SURVEYS AGGREGATED BY THE HEALTHY COMMUNITIES INSTITUTE AND ORGANIZED AT HEALTHYKLAMATH.ORG INDICATE A RANGE OF NEEDS. AMONG THE TOP ARE: - ADULTS 65+ WITH INFLUENZA VACCINATION - ADULTS 65+ WITH PNEUMONIA VACCINATION - BABIES WITH LOW BIRTH WEIGHT - MOTHERS WHO RECEIVED EARLY PRENATAL CARE - DEATH RATE DUE TO COLORECTAL CANCER (AGE ADJUSTED).FURTHER, THE NUMBER OF LOCAL RESIDENTS WHO SELF-REPORTED THEIR HEALTH AS "GOOD" OR BETTER IS SIGNIFICANTLY LOWER THAN THE COMPARISON GROUP.WITH THAT AS A BACKDROP, THE COMMUNITY PARTNERS BROKE THE KEY DRIVERS OF HEALTH ACCORDING TO THE DATA INTO BROADER CATEGORIES, AND ASKED AREA RESIDENTS TO ASSIGN PRIORITY RANKS TO THEM.NEARLY 1,000 PEOPLE PARTICIPATED IN THE ONLINE, SELF-SELECT SURVEY. DATA COLLECTION REMAINED OPEN NINE DAYS (ONE WORK WEEK AND TWO WEEKENDS). ACCORDING TO THE DATA, RESIDENTS IDENTIFIED OBESITY, ACCESS TO MENTAL HEALTH AND LIMITING THE EFFECTS OF SUBSTANCE AND ALCOHOL ABUSE AND TOBACCO USE TOP SHORT-TERM (12-18 MONTHS) PRIORITIES. SIMILARLY, THE PRIORITIES FOR AN INTERMEDIATE TERM (18-36 MONTHS) LEFT IN PLACE THREE OF THE SHORT-TERM PRIORITIES AND TO THE TOP PRIORITIES LIST HEALTH INSURANCE COVERAGE AND YOUTH MENTORING.THE LONG-TERM (3+ YEARS) PRIORITIES CLOSELY ALIGN WITH THE OTHER CATEGORIES WITH THE TOP PRIORITY TO DECREASE POVERTY WHILE INCREASING THE HIGH SCHOOL GRADUATION RATE, ENCOURAGING HEALTHIER LIFESTYLES WITH BETTER NUTRITION AND MORE EXERCISE OPPORTUNITIES, AND BROADER HEALTH INSURANCE COVERAGE COMPRISING THE TOP SPOTS. IT IS CLEAR TO MOST THAT THOSE WHO PARTICIPATED IN THE SURVEY RECOGNIZE THAT OBESITY AND ITS ASSOCIATED COMPONENTS, PRIMARILY HEALTHIER EATING HABITS AND INCREASED ACTIVITY, ARE CLOSELY LINKED TO A VARIETY OF OTHER UNHEALTHFUL CONDITIONS. FURTHER, THERE IS A RECOGNITION THAT IN ORDER FOR THE CHANGES TO BE MORE OR LESS PERMANENT REQUIRES BROAD-BASED SYSTEMIC CHANGES RATHER THAN SO-CALLED INSTANT FIXES.THE COMMUNITY COALITION, LED IN NO SMALL MEASURE BY SKY LAKES MEDICAL CENTER AND RESPONSIBLE FOR ENSURING THERE IS PROGRESS TOWARD MAKING IMPROVEMENTS IN THE PRIORITIES, BROKE THE SHORT-, INTERMEDIATE- AND LONG-TERM PRIORITIES INTO AN EIGHT-POINT PROJECT LIST. SUCCESS ON ANY OF THE POINTS SUPPORTS PROGRESS ON OTHER POINTS.COMMUNITY PARTNERS SEEKING BETTER HEALTH TEAMS PARTICIPATING IN THE HEALTHY KLAMATH INITIATIVE WERE FORMED AROUND:1. OBESITY, HEALTH EATING, EXERCISE2. ACCESS TO MENTAL HEALTH3. SUBSTANCE AND ALCOHOL ABUSE4. TRANSPORTATION5. YOUTH MENTORING6. INFRASTRUCTURE7. DECREASING POVERTY, AND8. HEALTH POLICY CHANGES.NONE OF THE ISSUES CAN BE RESOLVED WITHOUT CONSIDERABLE ENERGY AND RESOURCES, YET PROGRESS IS BEING MADE. FOR INSTANCE, SKY LAKES MEDICAL CENTER HIRED A PHYSICIAN AND NURSE, BOTH WITH PUBLIC HEALTH CREDENTIALS, TO OPEN AND OPERATE A FIRST-EVER "WELLNESS CENTER" AIMED SPECIFICALLY AT IMPROVING OBESITY-RELATED HEALTH.AT THE SAME TIME, SKY LAKES MEDICAL CENTER HAS MADE SIGNIFICANT CONTRIBUTIONS TO SUPPORT BETTER NUTRITION AND INCREASED PHYSICAL ACTIVITY. ALSO, SKY LAKES MEDICAL CENTER HAS COMMITTED TO BE A MAJOR SOURCE OF ALTERNATE REVENUE TO ENSURE THE MUNICIPAL POOL CONTINUES TO HAVE SWIMMING OPPORTUNITIES, RECOGNIZING IT AS AN IMPORTANT TYPE OF ACTIVITY FOR MANY PEOPLE, PARTICULARLY MOBILITY IMPAIRED INDIVIDUALS. SKY LAKES MEDICAL CENTER AND COMMUNITY PARTNERS ARE ACTIVELY IMPROVING ACCESS TO MENTAL HEALTH THROUGH A VARIETY OF MECHANISMS. THE MEDICAL CENTER, FOLLOWING A RIGOROUS RECRUITING EFFORT, HAS ATTRACTED TO THE COMMUNITY A PSYCHIATRIST TO PRACTICE AT THE NEWLY FORMED KLAMATH BASIN BEHAVIORAL HEALTH. THE ADDITION OF THE PROVIDER WILL LEVERAGE ADDITIONAL MENTAL HEALTH SERVICES FOR THE REGION.EFFORTS ARE UNDER WAY TO INCREASE: - THE AWARENESS AND THE FREQUENCY OF CANCER SCREENING OPPORTUNITIES TO ENCOURAGE AND SUPPORT THE EARLY DETECTION OF TUMORS; - DIRECT INTERVENTIONS FOR PEOPLE AT RISK OF DIABETES OR WHO HAVE BEEN DIAGNOSED WITH DIABETES TO IMPROVE THEIR CONDITIONS WITHOUT HOSPITALIZATION; AND - AWARENESS OF THE BENEFITS OF REGULAR LOW-IMPACT EXERCISES TO IMPROVE HEALTH AS WELL AS TO CONTROL AN ASSORTMENT OF CHRONIC DISEASES.WORKING WITH PHYSICIANS AND OTHER MEDICAL PROFESSIONALS, SKY LAKES MEDICAL CENTER ACTIVELY PROMOTES PRE-NATAL EDUCATION AMONG THE TARGET DEMOGRAPHIC BY OFFERING NO-CHARGE CHILDBIRTH PREPARATION CLASSES. THE MEDICAL CENTER ALSO HAS UNDERWAY A MORE EXPANSIVE PROGRAM USING NON-TRADITIONAL METHODS TO GET APPROPRIATE NUTRITION, EXERCISE AND CHILDBIRTH PREPARATION INFORMATION TO FIRST-TIME MOTHERS. MEASUREMENT DATA COLLECTED ON THE PROGRAMS ARE INCOMPLETE SO FIRM CONCLUSIONS REGARDING THEIR SUCCESS WOULD NOT BE APPROPRIATE. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 12H: HOUSEHOLD SIZE AND A MAXIMUM OUT-OF-POCKET EXPENDITURE. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 18E: SKY LAKES EMPLOYS A FIRM, CHAMBERLIN EDMONDS, THAT QUALIFIES PATIENTS FOR BENEFIT PROGRAMS. THEY SCREEN ALL OF SKY LAKES' UNINSURED PATIENTS FOR POSSIBLE MEDICAID, MEDICARE AND/OR DISABILITY BENEFITS. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 20D: SKY LAKES IS AWAITING CLARIFICATION ON 501(R) REGULATIONS, WHICH ARE PROPOSED. SKY LAKES MEDICAL CENTER PART V, SECTION B, LINE 22: SOME PATIENTS ARE ONLY ELIGIBLE FOR AN ANNUAL MAXIMUM OUT-OF-POCKET REDUCTION. PART VI, LINE 2: BESIDES FORMAL CONVERSATIONS WITH COMMUNITY PARTNERS AND MEDICAL COLLABORATORS, SKY LAKES MEDICAL CENTER ACTIVELY PARTNERS WITH AGENCIES SUCH AS THE KLAMATH COUNTY HEALTH DEPARTMENT AND THE UNITED WAY OF THE KLAMATH BASIN IN HEALTH-IMPROVEMENT INITIATIVES. THE HEALTH DEPARTMENT, IN CONJUNCTION WITH THE OREGON HEALTH DEPARTMENT, PERIODICALLY PERFORMS HEALTH ASSESSMENTS OF THE PEOPLE IN THE COMMUNITIES SERVED BY SKY LAKES. THE MEDICAL CENTER WORKS WITH LOCAL HEALTH AUTHORITIES TO DETERMINE THE HEALTH INITIATIVES THAT CAN BE JOINTLY ADDRESSED BY COMMUNITY LEADERS, WITH SKY LAKES MEDICAL CENTER SERVING A SIGNIFICANT LEADERSHIP ROLE. FURTHER, MEDICAL CENTER LEADERS USE INFORMATION AND DATA TRENDING FROM THE ROBERT WOOD JOHNSON FOUNDATION-SPONSORED UNIVERSITY OF WISCONSIN "COUNTY HEALTH RANKINGS" STUDY TO IDENTIFY SPECIFIC OPPORTUNITIES FOR IMPROVEMENT. COMMUNITY MEMBERS' PERCEPTIONS REGARDING HEALTH NEEDS ARE CAPTURED IN NON-SCIENTIFIC SURVEYS CONDUCTED AT THE CONCLUSION OF FREE HEALTH- AND WELLNESS-RELATED SEMINARS AND SIMILAR COMMUNITY EVENTS HOSTED BY THE MEDICAL CENTER. PART VI, LINE 3: SKY LAKES MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY AND APPLICATION FOR ASSISTANCE IS LOCATED ON THE HOSPITAL'S WEBSITE, IS REFERENCED IN THE ONLINE BILL-MANAGEMENT SECTION OF THE SITE, AND IS FEATURED IN THE MEDICAL CENTER'S ANNUAL REPORT AND PUBLISHED IN THE ANNUAL LIVE HEALTHY MAGAZINE. THE ANNUAL REPORT IS MAILED TO SOME 2,300 HOUSEHOLDS IN THE AREA AND THE MAGAZINE IS DISTRIBUTED TO ROUGHLY 17,000 HOUSEHOLDS IN THE MEDICAL CENTER'S CATCHMENT AREA USING THE LOCAL NEWSPAPER'S DISTRIBUTION NETWORK; BOTH ARE AVAILABLE ONLINE AND THE MAGAZINE IS PROMOTED VIA THE NEWSPAPER. THE FINANCIAL ASSISTANCE POLICY ALSO IS AVAILABLE WHEN SERVICES ARE PERFORMED. IN ADDITION, UNINSURED PATIENTS ARE PROVIDED PATIENT ADVOCACY BASED ELIGIBILITY AND ENROLLMENT SERVICES FOR MEDICAID AND OTHER BENEFIT PROGRAMS.THE MEDICAL CENTER ENSURES INFORMATION ABOUT FINANCIAL ASSISTANCE AND APPLICATIONS FOR ASSISTANCE IS AT ALL PATIENT REGISTRATION AREAS AND OUR SPECIALLY TRAINED FINANCIAL COUNSELORS HELP APPLICANTS COMPLETE THE FORM. ADDITIONALLY, FINANCIAL COUNSELORS TELEPHONE UNINSURED PATIENTS WITH LARGE BALANCES TO PROACTIVELY OFFER ASSISTANCE.OUR ABILITY TO OFFER FINANCIAL ASSISTANCE IS CLEARLY LISTED ON EVERY STATEMENT AND MOST FORM LETTERS WE MAIL. IT ALSO IS COVERED DURING COURTESY PHONE CALLS IF THERE IS MENTION OF DIFFICULTY IN PAYING MADE. THE ASSISTANCE ALSO IS DISCUSSED IF DIFFICULTY IN PAYING IS MENTIONED DURING INCOMING PHONE CALLS.IN ADDITION, SKY LAKES PROVIDES INFORMATION ABOUT FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS. WE HAVE ENGAGED THE SERVICES OF CHAMBERLIN EDMONDS, A COMPANY THAT SPEAKS WITH ALL UNINSURED INPATIENTS WHO MEET CLEARLY DEFINED CRITERIA.CHAMBERLIN EDMONDS STAFF ALSO REVIEW ALL QUALIFYING OUTPATIENT ACCOUNTS AND CONTACT PATIENTS TO DISCUSS THEIR ELIGIBILITY. THOSE STAFF FURTHER ASSIST PATIENTS IN COMPLETING FINANCIAL ASSISTANCE APPLICATIONS IF THEY ARE UNSUCCESSFUL GETTING ON A GOVERNMENT PROGRAM.BESIDES THE MAIN MEDICAL CENTER, THE SKY LAKES CANCER TREATMENT CENTER ALSO HAS FINANCIAL COUNSELORS WHO ASSIST WITH PHARMACEUTICAL CO-PAY RELIEF THROUGH THE DRUG MANUFACTURERS, RELIEVING PATIENTS OF SOME OF THAT FINANCIAL OBLIGATION. THE MEDICAL CENTER, THROUGH A THIRD-PARTY RELATIONSHIP, ROUTINELY PROVIDES NO-CHARGE MEDICATIONS TO INDIGENT PATIENTS THROUGH MAJOR PHARMACEUTICAL COMPANIES. PART VI, LINE 4: COMMUNITIES IN A 10,000-SQUARE MILE AREA ENCOMPASSING SOUTH-CENTRAL OREGON AND NORTH-CENTRAL CALIFORNIA COMPRISE THE SKY LAKES MEDICAL CENTER SERVICE AREA. WHILE KLAMATH COUNTY IS THE LARGEST POLITICAL UNIT IN THE SERVICE AREA, A TOTAL OF ROUGHLY 80,000 TO 100,000 PEOPLE IN TWO OREGON COUNTIES AND TWO CALIFORNIA COUNTIES RELY ON SKY LAKES FOR THEIR ACUTE HEALTHCARE NEEDS.CENSUS DATA FROM 2010 SHOW KLAMATH COUNTY'S POPULATION AT 66,380, A 4.1 PERCENT INCREASE SINCE 2000 AND 15 PERCENT GROWTH FROM 1990. THIS COMPARES TO A 35 PERCENT INCREASE FOR OREGON AS A WHOLE. KLAMATH COUNTY IS A BIT OLDER THAN OREGON OVERALL AND IS AGING AT A SLIGHTLY FASTER PACE THAN THE STATE. DATA FOR KLAMATH COUNTY SHOW 18 PERCENT OF THE POPULATION IS 65 YEARS OR OLDER AND 22 PERCENT ARE YOUNGER THAN 18. THE POPULATION'S GENDER SPLIT IS ALMOST EVEN WITH 50.1 PERCENT FEMALE.THE MEDIAN HOUSEHOLD INCOME IN THE COUNTY IN OCTOBER 2013 FISCAL WAS REPORTED TO BE APPROXIMATELY $37,000, WHICH PUTS IT ABOUT $10,000 LESS THAN THE STATEWIDE MEDIAN. ALSO, ABOUT A FIFTH OF THE COUNTY'S POPULATION IS BELOW THE POVERTY LEVEL. THAT IS ROUGHLY 6 PERCENT GREATER THAN STATEWIDE.THE POPULATION SERVED BY THE MEDICAL CENTER IS FURTHER DESCRIBED BY THE RELATIVE RANKINGS FROM THE UNIVERSITY OF WISCONSIN STUDY. THE 2013 REPORT NOTES KLAMATH COUNTY IS RANKED 31ST OUT OF 33 RANKED OREGON COUNTIES ON SUCH FACTORS AS:- POOR OR FAIR HEALTH (18 PERCENT VS THE NATIONAL BENCHMARK OF 10 PERCENT AND THE OREGON BENCHMARK OF 14 PERCENT),- ADULT SMOKING (23 PERCENT VS 13 PERCENT NATIONALLY AND 17 PERCENT IN OREGON),- UNINSURED ADULTS (22 PERCENT VS 11 PERCENT NATIONALLY AND 20 PERCENT IN OREGON),- PRIMARY CARE PROVIDERS (1,206:1 VS 1,067:1 NATIONALLY AND 1,134:1 IN OREGON),- UNEMPLOYMENT (12.2 PERCENT VS 5.0 PERCENT NATIONALLY AND 9.5 IN OREGON),- CHILDREN IN POVERTY (31 PERCENT VS 14 PERCENT NATIONALLY AND 23 PERCENT IN OREGON), AND- VIOLENT CRIME RATE (251 VS 66 NATIONALLY AND 257 IN OREGON).DURING 2013, APPROXIMATELY 30 PERCENT OF THE APPROXIMATELY 19,300 VISITS TO SKY LAKES MEDICAL CENTER'S EMERGENCY DEPARTMENT RESULTED IN AN INPATIENT STAY. ABOUT TWO-THIRDS OF THE INPATIENTS AT SKY LAKES CAME IN VIA THE ER, VERSUS THE STATE AVERAGE OF ABOUT HALF. PART VI, LINE 5: BESIDES PROVIDING HIGH-QUALITY HEALTHCARE, SKY LAKES MEDICAL CENTER FURTHERS ITS TAX-EXEMPT PURPOSE AND FULFILLS ITS MEDICAL MISSION TO THE COMMUNITY BY PROVIDING OR SUBSIDIZING NUMEROUS CLASSES, SUPPORT GROUPS, SCREENINGS AND SELF-HELP PROGRAMS; A FREE GENERALCOMMUNITY HEALTH FAIR ATTENDED BY SOME 2,500 PEOPLE A YEAR, AND A SEPARATE FREE FAIR FOCUSED ON INFORMATION FOR PEOPLE WITH DIABETES WITH APPROXIMATELY 500 PEOPLE ATTENDING; A VARIETY OF LECTURES AIMED AT ENCOURAGING GREATER FITNESS AND INCLUDING MONTHLY WALKS/HIKES, AND TWICE-A-MONTH ORGANIZED WALKS HOSTED BY PHYSICIANS FROM CASCADES EAST FAMILY MEDICINE, WHICH IS PART OF THE SKY LAKES FAMILY, TWO SATURDAYS A MONTH. ALSO, THE MEDICAL CENTER SPONSORS AMERICAN CANCER SOCIETY FREEDOM FROM SMOKING CLASSES TAUGHT BY A COMMUNITY PARTNER. SPECIALLY TRAINED NURSES PROVIDE CHILDBIRTH PREPARATION CLASSES AND LACTATION EDUCATION. THESE EVENTS ARE EITHER FREE OR LOW COST, AND SCHOLARSHIPS ARE AVAILABLE.TO ENCOURAGE PEOPLE TO BE MORE ACTIVE, SKY LAKES PROMOTES PEDOMETER GIVE-AWAYS AND HAS DISTRIBUTED THEM TO SOME 3,000 PEOPLE INTERESTED IN KEEPING TRACK OF THEIR STEPS EN ROUTE TO A DAILY GOAL OF 10,000 STEPS.MANY OF THOSE PEOPLE ALSO PARTICIPATED IN THE FREE 'COUCH TO 5K' SERIES, WHICH DEMONSTRATED WAYS TO BE MORE ACTIVE. THE NO-CHARGE LECTURES INCLUDE PRIZE DRAWINGS AND WALKS ALONG AREA TRAILS.THE SKY LAKES FAMILY BIRTH CENTER HOSTS FREE CLASSES TO HELP SOON-TO-BE SIBLINGS AND NO-CHARGE SESSIONS TO ENSURE THE EMOTIONAL HEALTH OF MOMS DURING AND AFTER PREGNANCY.SKY LAKES MEDICAL CENTER IS THE PRINCIPAL UNDERWRITER FOR CASCADES EAST FAMILY MEDICINE, A CLINIC AND A FAMILY PRACTICE RESIDENCY PROGRAM OPERATED IN PARTNERSHIP WITH OREGON HEALTH & SCIENCE UNIVERSITY. SKY LAKES MEDICAL CENTER'S FINANCIAL SUPPORT AMOUNTS TO MORE THAN $4 MILLION. THE MEDICAL CENTER CARRIES THE VAST MAJORITY OF COSTS INCURRED IN THE RUNNING OF THE CHILD ABUSE RESOURCE AND EDUCATIONAL SERVICES AGENCY THAT SERVES KLAMATH AND LAKE COUNTIES.CASCADES EAST ALSO OPERATES A MOBILE CLINIC THAT PROVIDES NO-CHARGE HEALTHCARE SERVICES TO UN- AND UNDERINSURED POPULATIONS IN THE REGION. THE CASCADES EAST MEDICAL STAFF LOG MORE THAN 1,000 MILES IN THE RV CLINIC EACH YEAR AND PERFORM MORE THAN 200 PATIENT EXAMS. BESIDES REGULAR CLINICS AT KLAMATH FALLS LOCATIONS, THE RV VISITS THE RURAL COMMUNITIES OF GILCHRIST AND SPRAGUE RIVER. THE FUEL, MAINTENANCE, AND SUPPLIES ARE ALL A PAID FOR BY SKY LAKES MEDICAL CENTER; THE SUM EXCEEDS $6,000 A YEAR.SKY LAKES CONTRIBUTES $10,000 A YEAR AND PROVIDES STAFF TO HELP COORDINATE AND PROVIDE COLLATERAL SUPPORT IN THE WAY OF ADDITIONAL MULTI-MEDIA ADVERTISING TO FURTHER THE MESSAGE OF THE LOCAL 'STOP THE HURT' AND 'PERIODS OF PURPLE CRYING' CAMPAIGNS. THE PROGRAMS ARE AIMED AT STOPPING INCIDENTS OF INFANT AND CHILD ABUSE AT THE HANDS OF ADULTS.SIMILARLY, SKY LAKES IS AMONG THE COMMUNITY PARTNERS INVESTING IN THE 'SOUTHERN OREGON METH PROJECT,' WHICH TARGETS DRUG USE BY TEENS. THE MEDICAL CENTER ANNUALLY CONTRIBUTES $9,000 A YEAR TO THE PUBLIC AWARENESS CAMPAIGN.IN ADDITION, KLAMATH COUNTY IS A PHYSICIAN-SHORTAGE AREA SO PHYSICIAN RECRUITMENT EFFORTS ARE ALSO UNDERWRITTEN BY THE MEDICAL CENTER RATHER THAN LOCAL MEDICAL PRACTICES INCURRING THAT EXPENSE. THE MEDICAL CENTER INVESTS UPWARDS OF $1 MILLION A YEAR IN RECRUITING ACTIVITIES. THIS DOES NOT INCLUDE THE START-UP COSTS PAID BY THE MEDICAL CENTER FOR NEW PHYSICIANS ESTABLISHING THEIR PRACTICES IN KLAMATH FALLS.SKY LAKES PROVIDES FREE EDUCATION IN OR FOR THE SCHOOLS THROUGH ITS PARTNERSHIP WITH OREGON STATE UNIVERSITY EXTENSION'S NUTRITION EDUCATION PROGRAM. THE MEDICAL CENTER ALSO PARTNERS WITH OSU EXTENSION FOR THE EDUCATION SERIES FOR PEOPLE WITH DIABETES, AND THE THREE-CLASS 'MASTERY OF AGING WELL' SERIES. AND A NUMBER OF SKY LAKES MEDICAL CENTER EMPLOYEES PROVIDE VOLUNTEER EDUCATIONAL SUPPORT IN THE FORM OF TEACHING, MENTORING, PROGRAM DEVELOPMENT, AND TOURS AND DEMONSTRATIONS FOR LOCAL SCHOOLS AND COLLEGES.OTHER PARTNERSHIPS HELP ENSURE THE SUCCESS OF PROGRAMS SUCH AS:- THE LOCAL KLAMATH AND LAKE COMMUNITY ACTION SERVICES PROGRAM BY DONATING MATERIAL FOR ITS PROGRAM TO PROVIDE QUALIFYING INDIVIDUALS AND FAMILIES ACCESS TO MEDICAL AND DENTAL CARE, HYGIENE RESOURCES AND THE LIKE;- THE KLAMATH COUNTY RELAY FOR LIFE BY CONTRIBUTING $2,500 TOWARD CANCER RESEARCH AND PROVIDING SOME 700 SERVINGS OF HOME-MADE SOUP TO THOSE AT THE EVENT;- THE RED CROSS BY GIVING AT NO-CHARGE SPACE IN SKY LAKES FACILITIES FOR COMMUNITY BLOOD DRIVES;- FRIENDS OF THE CHILDREN-KLAMATH FALLS BY UNDERWRITING THE ANNUAL 'FRIEND RAISER' EVENT SO PROCEEDS FROM THE EVENT GO ENTIRELY TO SUPPORTING THE ORGANIZATION'S MISSION OF HELPING CHILDREN;- PROVIDING SIGNIFICANT FUNDING OF LOCAL ATHLETIC PROGRAMS TO NURTURE A LIFELONG HABIT OF PHYSICAL ACTIVITY THROUGH PARTICIPATION IN SPORTS; - THE LOCAL CHAPTERS OF THE MARCH OF DIMES, MUSCULAR SCLEROSIS ORGANIZATIONS, AND LOCAL EARLY CANCER DETECTION CAMPAIGNS BY CONTRIBUTING HUNDREDS OF DOLLARS EACH TO THEIR MISSIONS. THE MEDICAL CENTER AND LOCAL PARTNERS PROMOTE EARLY DETECTION OF CANCER IN A SIX-MONTH CAMPAIGN THAT CULMINATES AT THE JULY RELAY FOR LIFE EVENT.- THE 'BASIN HEALTHY CHOICES' INITIATIVE COORDINATED BY THE KLAMATH COUNTY HEALTH DEPARTMENT AND THE HEALTHY ACTIVE KLAMATH COALITION, WHICH INCLUDES SKY LAKES MEDICAL CENTER. SKY LAKES CONTRIBUTES COUNTLESS HOURS OF STAFF TIME AND TALENT, AS WELL AS FACILITY AND OTHER RESOURCES, IN THE CAMPAIGN AIMED AT IMPROVING THE HEALTH OF PEOPLE IN THE REGION BY PROMOTING WORKPLACE WELLNESS, BETTER NUTRITION THROUGH FOOD CHOICES, AND INCREASED PHYSICAL ACTIVITY.SOME OTHER SKY LAKES COMMUNITY PARTNERSHIPS INCLUDE:- AMERICAN ASSOCIATION OF UNIVERSITY WOMEN- AMERICAN CANCER SOCIETY- KLAMATH GOSPEL MISSION- AREA PUBLIC SCHOOLS AND STUDENTS- KLAMATH COMMUNITY COLLEGE AND STUDENTS- KLAMATH COUNTY CASA - KLAMATH COUNTY CHAMBER OF COMMERCE- KLAMATH BASIN BEHAVIORAL HEALTH- KLAMATH FIRE PREVENTION COOPERATIVE- KLAMATH HOSPICE- KLAMATH-LAKE FOOD BANK- MULTIPLE SCLEROSIS SOCIETY- 'OPERATION PROM NIGHT' TO PREVENT DISTRACTED DRIVING- OREGON INSTITUTE OF TECHNOLOGY, ITS FOUNDATION AND STUDENTS (CLINICAL PRECEPTING, ETC.)- PREGNANCY HOPE CENTER- SANFORD HEALTH FOUNDATION- UNITED WAY OF THE KLAMATH BASIN- KLAMATH-LAKE LAND TRUST TO PRESERVE AND PROTECT AREA HABITATS- INTERNATIONAL MIGRATORY BIRDS DAY ACTIVITIES FOR CHILDREN- LOCAL CHILDREN AT CAMP ROSENBAUM IN COOPERATION WITH KLAMATH HOUSING AUTHORITY AND THE OREGON AIR NATIONAL GUARD AT KINGSLEY FIELD- VETERANS ORGANIZATION AT OREGON INSTITUTE OF TECHNOLOGY- KLAMATH PROMISE'S MISSION OF 100 PERCENT HIGH SCHOOL GRADUATION- KLAMATH ICE SPORTS- ROSS RAGLAND THEATER'S MISSION TO BRING PERFORMING ARTS TO THE COMMUNITY- HEALTHY KLAMATH, A COALITION OF LIKE-MINDED PUBLIC AGENCIES, CIVIC ORGANIZATIONS AND PRIVATE INDIVIDUALS DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITY- OREGON DEPARTMENT OF HUMAN SERVICES- CITY OF KLAMATH FALLS-OPERATED ELLA REDKEY SWIMMING POOL TO PROVIDE SWIMMING LESSONS FOR AREA THIRD-GRADERS AND TO PROVIDE INFRASTRUCTURE ASSISTANCE REPORTS FILED WITH STATES PART VI, LINE 7 OR 1 KLAMATH COUNTY SCHOOL DISTRICT 10501 WASHBURN WAY KLAMATH FALLS OR 97603 936000543 GOVERNMENT ENTITY 15881 HOSA PROGRAM ASSISTANCE SKY LAKES MEDICAL CENTER FOUNDATION 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 930946020 501(C)(3) 9834 INFECTIOUS DISEASE CONFERENCE, CARES AWARENESS & PREVENTION EDUCATION CITY OF KLAMATH FALLS 500 KLAMATH AVENUE KLAMATH FALLS OR 97601 936002195 GOVERNMENT ENTITY 50000 FUNDING COMMUNITY SWIMMING POOL 3 0 EMPLOYEE STUDENT LOAN FORGIVENESS 12 68358 EXTERNSHIP STIPENDS 7 24000 STUDENT LOAN ASSISTANCE TO EMPLOYEES 19 57541 PATIENT ASSISTANCE 118 26774 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE BOARD OF DIRECTORS MAKES DECISIONS ON LARGE GRANT AWARDS. SCHOLARSHIP AWARDS ARE BASED ON A WRITTEN POLICY. OTHER STIPENDS AND EDUCATIONAL SUPPORT REQUIRE, RESPECTIVELY, WORKED HOURS OR MINIMUM GRADING CRITERIA. PATIENT ASSISTANCE GRANTS ARE BASED ON ASSESSMENT OF NEED BY ASSIGNED PERSONNEL. X X X 0 0 0 0 0 0 0 0 0 PAUL R STEWART 340703 0 190000 0 0 0 12500 0 14388 0 557591 0 0 0 GRANT NISKANEN MD 188718 0 0 0 0 0 7356 0 0 0 196074 0 0 0 RICHARD RICO 300016 0 58910 0 0 0 12500 0 19596 0 391022 0 0 0 PATRICK MAVEETY MD 450572 0 0 0 0 0 12500 0 8724 0 471796 0 0 0 STANTON T SMITH MD 420333 0 0 0 0 0 12500 0 19344 0 452177 0 0 0 RICHARD DEVORE MD 340858 0 0 0 0 0 12500 0 18360 0 371718 0 0 0 JAYMIE PANUNCIALMAN MD 271669 0 0 0 0 0 12443 0 19596 0 303708 0 0 0 W CLAY MCCORD MD 233014 0 0 0 0 0 10572 0 14388 0 257974 0 0 0 A KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITY 931061020 498413DQ3 2006-08-31 39329258 REVENUE AND REFUNDING; MERLE WEST MEDICAL CENTER PROJECT 1 1 0 B KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITY 931061020 498413EF6 2012-11-29 18288334 REFUNDING OF 2002 BONDS; ENERGY EFFICIENCY COSTS; RESERVE FUND 0 0 0 A 39329258 558445 1170952 15000000 22599861 2007 0 1 1 1 B 11772436 18288334 59879 257477 6198542 2013 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 PAUL STEWART PRES/CEO LIFE INSURANCE POLICY PURCHASE X 150000 150313 0 1 1 150313 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE CONTROLLER, CFO AND OTHER STAFF BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE DUTY OF THE BOARD OF DIRECTORS OF SKY LAKES MEDICAL CENTER TO SAFEGUARD THE TAX EXEMPT STATUS OF SKY LAKES MEDICAL CENTER, AND AS SUCH THE BOARD WILL TAKE SERIOUSLY ANY CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER OR POTENTIAL BOARD MEMBER. ALL BOARD MEMBERS AND POTENTIAL MEMBERS MUST DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST. AN UPDATED STATEMENT OF SUCH POTENTIAL CONFLICTS SHALL BE SUBMITTED YEARLY BY ALL BOARD MEMBERS FOR REVIEW AT THE BOARD'S ANNUAL MEETING. AFTER DISCLOSURE OF THE POTENTIAL CONFLICT OF INTEREST AND AFTER ANY DISCUSSION WITH THE INTERESTED PARTY, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE MINUTES OF THE BOARD AND ALL COMMITTEES OF THE BOARD SHALL CONTAIN 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST; 2) THE NATURE OF THE FINANCIAL INTEREST; 3) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR THE DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT; 4) THE CONTENT OF THE DISCUSSION INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 5) ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND, 6) THE BOARD OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARATIVE DATA FOR CEO AND ALL VP POSITIONS. FOR THE CEO POSITION, THE COMPENSATION COMMITTEE COMPLETES A PERSONNEL ACTION FORM, WHICH IS SIGNED BY THE BOARD CHAIR. FOR ALL VP POSITIONS, THE COMMITTEE ACTS ON THE RECOMMENDATIONS MADE BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL MADE AVIALABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE ON PASSTHROUGH INCOME -7,446. SOUTHERN OREGON EMERGENCY CARE LLC 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 611595709 PHYSICIAN SERVICES OR 0 376215 SKY LAKES MEDICAL CENTER SKY LAKES MEDICAL CENTER FOUNDATION 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 930946020 FUNDRAISING AND STEWARDSHIP; SUPPORT MED CENTER OR 501(C)(3) 11C SKY LAKES MEDICAL CENTER 0 KLAMATH CARE SERVICES INC 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 930946018 SUPPORT MED CENTER (INACTIVE) OR 501(C)(3) 11C SKY LAKES MEDICAL CENTER 0 KLAMATH MEDICAL BUSINESS CENTER LLC 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 020731372 REAL AND PERSONAL PROPERTY RENTAL OR SKY LAKES MEDICAL CENTER INVESTMENT 80516 501260 0 7352 1 0.50000 WEST PHYSICIAN SERVICES LLC 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 870696029 PHYSICIAN SERVICES OR SKY LAKES MEDICAL CENTER C -1190647 2552477 1.00000 1 PREFERRED HEALTH PLAN INC 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 931304315 HEALTH INSURANCE OR SKY LAKES MEDICAL CENTER C 0.87000 1 0 1 1 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 1 KLAMATH MEDICAL BUSINESS CENTER LLC K 121968 CASH TRANSFERRED WEST PHYSICIAN SERVICES LLC D 337657 BOOK CHANGE IN LIABILITY PREFERRED HEALTH PLAN INC S 140400 LIQUIDATING TRANSFER