GOOD SAMARITAN HOSPITAL CORVALLIS: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN HOSPITAL CORVALLIS (EIN 93-0391573)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201423169349303102
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-12T12:40:45-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930623286 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AKT LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5665 SW MEADOWS RD SUITE 200 | AddressLine1 |
| City | LAKE OSWEGO | City |
| State | OR | State |
| ZIP Code | 97035 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930391573 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN HOSPITAL CORVALLIS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 5417684773 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O SHS ACCOUNTING PO BOX 3000 | AddressLine1 |
| City | CORVALLIS | City |
| State | OR | State |
| ZIP Code | 973393000 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL B SMITH | PersonNm |
| Person Title | VP FINANCE/CFO | PersonTitleTxt |
| Phone | 5417684773 | PhoneNum |
| Signature | 2014-11-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOYLYN ANKENEY | PreparerPersonNm |
| PTIN | P00366587 | PTIN |
| Phone | 5036204489 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN REGIONAL MEDICAL CTR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LARRY A MULLINS DHA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 NW SAMARITAN DR | AddressLine1 |
| City | CORVALLIS | City |
| State | OR | State |
| ZIP Code | 97330 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $333,412,356 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SAMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY THROUGH ITS MEDICAL AND SURGICAL HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 2212 | TotalEmployeeCnt |
| Total Volunteers | 261 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $612,412 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,454,369 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $325,735,991 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $319,361,967 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,992,808 | PYInvestmentIncomeAmt |
| CY Investment Income | $967,032 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,268,514 | PYOtherRevenueAmt |
| CY Other Revenue | $2,621,305 | CYOtherRevenueAmt |
| PY Total Revenue | $331,609,725 | PYTotalRevenueAmt |
| CY Total Revenue | $324,404,673 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $270,830 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $255,095 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $176,373,021 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $176,436,353 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $213,614 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $155,206,418 | PYOtherExpensesAmt |
| CY Other Expenses | $155,882,852 | CYOtherExpensesAmt |
| PY Total Expenses | $331,850,269 | PYTotalExpensesAmt |
| CY Total Expenses | $332,574,300 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$240,544 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,169,627 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $180,058,789 | TotalAssetsBOYAmt |
| Total Assets EOY | $181,709,661 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $88,946,727 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $81,812,689 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $91,112,062 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $99,896,972 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | GOOD SAMARITAN HOSPITAL, CORVALLIS (GSH) ACHIEVES ITS MISSION OF IMPROVING THE HEALTH AND WELL BEING OF THE COMMUNITY THROUGH ITS MEDICAL AND SURGICAL HOSPITAL AND HEALTHCARE CLINICS PROVIDING OUTPATIENT CARE SERVICES AT SEVERAL AREA LOCATIONS.GSH IS A MEMBER OF SAMARITAN HEALTH SERVICES (SHS), A REGIONAL NETWORK OF HOSPITALS, PHYSICIANS AND SENIOR CARE FACILITIES. THE NETWORK, FORMED IN THE LATE 1990'S, SERVES APPROXIMATELY 290,000 RESIDENTS IN LINN, BENTON, LINCOLN AND PORTIONS OF POLK AND MARION COUNTIES IN OREGON. IT IS LOCALLY OWNED, AND ITS BOARDS OF DIRECTORS INCLUDE HOSPITAL LEADERS, PHYSICIANS AND COMMUNITY REPRESENTATIVES. GSH PROVIDES HEALTHCARE SERVICES REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, DISABILITY OR AGE. THE MISSION OF GSH IS TO ENHANCE COMMUNITY HEALTH AND ACHIEVE HIGH VALUE THROUGH QUALITY SERVICES ACROSS A CONTINUUM OF CARE. THE COLLECTIVE VISION OF THE SHS SYSTEM IS TO BE A VALUES-DRIVEN ORGANIZATION GOVERNED BY COMMUNITY MEMBERS, PHYSICIANS AND O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $296,138,914 | ExpenseAmt |
| Revenue | $319,561,423 | RevenueAmt |
| Desc | GOOD SAMARITAN HOSPITAL CORVALLIS (GSH), THE LARGEST HOSPITAL IN LINN, BENTON AND LINCOLN COUNTIES, OFFERS MORE THAN 22 MEDICAL SPECIALTIES INCLUDING COMPREHENSIVE CANCER CARE, A FULL-SERVICE CARDIOLOGY AND VASCULAR SURGERY PROGRAM, A SLEEP LAB, NEUROSURGERY AND OTHER REGIONAL SERVICES. GSH HAS MORE THAN 1,800 EMPLOYEES AND 200 VOLUNTEERS SERVING THE MEDICAL NEEDS OF THE COMMUNITY. IT IS LICENSED TO OPERATE 188 BEDS AND IS ONE OF ONLY THREE 'LEVEL 2' TRAUMA CENTERS IN THE STATE. DURING 2013, GSH SERVED 9,257 INPATIENTS, HAD 22,679 EMERGENCY DEPARTMENT VISITS, PERFORMED 9,640 SURGERIES AND DELIVERED 974 BABIES. IN ADDITION, GSH PERFORMED 75,899 IMAGING PROCEDURES, HAD 35,403 HOME HEALTH VISITS, AND HAD 192,330 PHYSICIAN CLINIC VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $255,095 | ExpenseAmt |
| Grant | $255,095 | GrantAmt |
| Desc | GRANTS AND ASSISTANCE PROVIDED BY GOOD SAMARITAN HOSPITAL CORVALLIS TO VARIOUS ORGANIZATIONS AND INDIVIDUALS TO BENEFIT THE COMMUNITY. SEE PART IX, LINES 1 AND 2 AND RELATED SCHEDULE I FOR MORE DETAILS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $296,394,009 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2212 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5417684773 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3000 | AddressLine1 |
| City | CORVALLIS | City |
| State | OR | State |
| ZIP Code | 973393000 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| BISHOP MICHAEL HANLEY | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEVE UERLINGS | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| NANCY SEIFERT | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GILBERT BECK | |||||||||
| BOARD TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| CLIFFORD A HALL MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD CRONK MD | |||||||||
| BOARD SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| REVEREND SIMON JUSTICE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| SHIRLEY PETERSON | |||||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| JUDY LIST | |||||||||
| BOARD VICE-CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| ERIC THOMPSON | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL CHEN MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $2,000 | $0 | $0 | ||||
| TIM HENNESSY | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| STEVEN W JASPERSON | |||||||||
| CEO/VP SOUTHERN CALIFORNIA OPS | 20.00 | $0 | $435,508 | $43,841 | 20.00 | Yes (X) | |||
| LARRY A MULLINS DHA | |||||||||
| CEO/CEO SHS | 10.00 | $0 | $1,192,819 | $270,731 | 30.00 | Yes (X) | |||
| DANIEL B SMITH | |||||||||
| VP FINANCE/CFO | 2.00 | $0 | $307,300 | $50,407 | 38.00 | Yes (X) | |||
| BECKY PAPE | |||||||||
| COO/CEO MVH | 30.00 | $0 | $311,663 | $50,234 | 10.00 | Yes (X) | |||
| KATHRYN M HALE | |||||||||
| VP NURSING | 40.00 | $191,160 | $0 | $34,321 | Yes (X) | ||||
| MICHAEL A MAY MD | |||||||||
| VP SMH MEDICAL DIRECTOR | 39.00 | $233,686 | $0 | $42,757 | 1.00 | Yes (X) | |||
| SCOTT WILSON | |||||||||
| VP ANCILLARY & SUPPORT SERVICES | 40.00 | $155,377 | $0 | $36,522 | Yes (X) | ||||
| JAMES RYAN MD | |||||||||
| PHYSICIAN | 40.00 | $656,105 | $0 | $50,443 | Yes (X) | ||||
| DONALD PENNINGTON DO | |||||||||
| PHYSICIAN | 40.00 | $746,346 | $0 | $47,789 | Yes (X) | ||||
| TOSHIO NAGAMOTO MD | |||||||||
| PHYSICIAN | 40.00 | $807,129 | $0 | $48,293 | Yes (X) | ||||
| RANDALL V BREAM MD | |||||||||
| PHYSICIAN | 40.00 | $621,694 | $0 | $43,893 | Yes (X) | ||||
| LUIS VELA DO | |||||||||
| PHYSICIAN | 40.00 | $892,408 | $0 | $50,231 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,305,905 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,247,290 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $769,462 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 296 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,454,369 | RelatedOrganizationsAmt |
| Total Contributions | $1,454,369 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $313,141,490 | $313,141,490 |
| RETAIL PHARMACY | 446110 | $5,422,902 | $5,422,902 |
| OTHER PATIENT REVENUE | 622110 | $797,575 | $797,575 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $319,361,967 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $473,994 | TotalRevenueColumnAmt |
| Exclusion | $473,994 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $784,070 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $150,069 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $634,001 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $634,001 | TotalRevenueColumnAmt |
| Exclusion | $634,001 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,570,344 | SecuritiesAmt |
| Other | $704,798 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,936,550 | SecuritiesAmt |
| Other | $845,554 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $633,794 | SecuritiesAmt |
| Other | -$140,756 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $493,038 | TotalRevenueColumnAmt |
| Exclusion | $493,038 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $138,024 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $75,510 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,514 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $62,514 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA | 722210 | $1,787,848 | $1,787,848 | |
| WELLNESS INSTRUCTION | 611600 | $85,687 | $85,687 | |
| MISCELLANEOUS REVENUE | 900099 | $35,108 | $35,108 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,147 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,147 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,924,790 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $324,404,673 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $319,561,423 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,388,881 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,479 | TotalAmt |
| Program Services | $216,479 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,616 | TotalAmt |
| Program Services | $38,616 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $695,825 | TotalAmt |
| Program Services | $503,925 | ProgramServicesAmt |
| Management And General | $191,900 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,245,387 | TotalAmt |
| Program Services | $130,025,341 | ProgramServicesAmt |
| Management And General | $3,133,390 | ManagementAndGeneralAmt |
| Fundraising | $86,656 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,639,251 | TotalAmt |
| Program Services | $10,383,476 | ProgramServicesAmt |
| Management And General | $248,892 | ManagementAndGeneralAmt |
| Fundraising | $6,883 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,361,446 | TotalAmt |
| Program Services | $21,823,860 | ProgramServicesAmt |
| Management And General | $523,119 | ManagementAndGeneralAmt |
| Fundraising | $14,467 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,494,444 | TotalAmt |
| Program Services | $9,266,191 | ProgramServicesAmt |
| Management And General | $222,111 | ManagementAndGeneralAmt |
| Fundraising | $6,142 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,670 | TotalAmt |
| Management And General | $136,670 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,400 | TotalAmt |
| Program Services | $3,400 | ProgramServicesAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,784,044 | TotalAmt |
| Program Services | $6,694,723 | ProgramServicesAmt |
| Management And General | $85,104 | ManagementAndGeneralAmt |
| Fundraising | $4,217 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,518 | TotalAmt |
| Program Services | $16,837 | ProgramServicesAmt |
| Management And General | $42,539 | ManagementAndGeneralAmt |
| Fundraising | $6,142 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,048,956 | TotalAmt |
| Program Services | $11,329,000 | ProgramServicesAmt |
| Management And General | $657,040 | ManagementAndGeneralAmt |
| Fundraising | $62,916 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,087,815 | TotalAmt |
| Program Services | $13,157,979 | ProgramServicesAmt |
| Management And General | $929,836 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,200,072 | TotalAmt |
| Program Services | $4,063,981 | ProgramServicesAmt |
| Management And General | $136,091 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,711 | TotalAmt |
| Program Services | $334,652 | ProgramServicesAmt |
| Management And General | $13,059 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $866,321 | TotalAmt |
| Program Services | $858,079 | ProgramServicesAmt |
| Management And General | $6,358 | ManagementAndGeneralAmt |
| Fundraising | $1,884 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,322,277 | TotalAmt |
| Program Services | $4,970,992 | ProgramServicesAmt |
| Management And General | $351,285 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,959,880 | TotalAmt |
| Program Services | $10,548,660 | ProgramServicesAmt |
| Management And General | $410,604 | ManagementAndGeneralAmt |
| Fundraising | $616 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,105,090 | TotalAmt |
| Program Services | $3,707,698 | ProgramServicesAmt |
| Management And General | $396,985 | ManagementAndGeneralAmt |
| Fundraising | $407 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $44,013,196 | $44,013,196 | ||
| PURCHASED SERVICES | $39,788,622 | $11,310,139 | $28,456,483 | $22,000 |
| DUES, TAXES, & LICENSES | $13,152,280 | $13,126,785 | $24,211 | $1,284 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,574,300 | TotalAmt |
| Program Services | $296,394,009 | ProgramServicesAmt |
| Management And General | $35,966,677 | ManagementAndGeneralAmt |
| Fundraising | $213,614 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,797 | BOYAmt |
| EOY | $11,603 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,789,636 | BOYAmt |
| EOY | $1,520,458 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,816,338 | BOYAmt |
| EOY | $49,227,560 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,143 | BOYAmt |
| EOY | $176,184 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,686,746 | BOYAmt |
| EOY | $5,901,094 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,086,653 | BOYAmt |
| EOY | $1,541,634 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $211,852,044 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $109,621,976 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,433,963 | BOYAmt |
| EOY | $102,230,068 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,050,129 | BOYAmt |
| EOY | $16,000,496 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $307,488 | BOYAmt |
| EOY | $281,180 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,577,896 | BOYAmt |
| EOY | $4,819,384 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,058,789 | BOYAmt |
| EOY | $181,709,661 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,250,916 | BOYAmt |
| EOY | $20,847,504 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $73,422 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,708,000 | BOYAmt |
| EOY | $3,708,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,099,917 | BOYAmt |
| EOY | $3,861,840 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,887,894 | BOYAmt |
| EOY | $53,321,923 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,946,727 | BOYAmt |
| EOY | $81,812,689 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,112,062 | BOYAmt |
| EOY | $99,896,972 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,112,062 | BOYAmt |
| EOY | $99,896,972 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,058,789 | BOYAmt |
| EOY | $181,709,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,169,627 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,022,273 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $15,932,264 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,430,883 | BeginningYearBalanceAmt |
| Contributions | $269,432 | ContributionsAmt |
| Investment Earnings Or Losses | $578,249 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $243,381 | GrantsOrScholarshipsAmt |
| End Year Balance | $6,035,183 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,758,581 | BeginningYearBalanceAmt |
| Contributions | $316,843 | ContributionsAmt |
| Investment Earnings Or Losses | $543,063 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $187,604 | GrantsOrScholarshipsAmt |
| End Year Balance | $5,430,883 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,975,845 | BeginningYearBalanceAmt |
| Contributions | $106,549 | ContributionsAmt |
| Investment Earnings Or Losses | -$131,912 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $191,901 | GrantsOrScholarshipsAmt |
| End Year Balance | $4,758,581 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,582,212 | BeginningYearBalanceAmt |
| Contributions | $211,952 | ContributionsAmt |
| Investment Earnings Or Losses | $443,652 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $261,971 | GrantsOrScholarshipsAmt |
| End Year Balance | $4,975,845 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,963,225 | BeginningYearBalanceAmt |
| Contributions | $107,306 | ContributionsAmt |
| Investment Earnings Or Losses | $645,769 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $134,088 | GrantsOrScholarshipsAmt |
| End Year Balance | $4,582,212 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.20130 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.79870 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,208,871 | OtherCostOrOtherBasisAmt |
| Book Value | $2,208,871 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $138,384,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,079,471 | DepreciationAmt |
| Book Value | $78,304,571 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,749,744 | OtherCostOrOtherBasisAmt |
| Depreciation | $489,278 | DepreciationAmt |
| Book Value | $2,260,466 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $59,441,150 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,103,306 | DepreciationAmt |
| Book Value | $14,337,844 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,068,237 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,949,921 | DepreciationAmt |
| Book Value | $5,118,316 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $102,230,068 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| PROFESSIONAL LIABILITY RESERVE | $2,011,000 |
| OTHER LIABILITIES | $424,928 |
| PAYABLE TO CONTRACTUAL AGENCIES | $4,647,691 |
| MINIMUM PENSION LIABILITY | $21,921,264 |
| ACCRUED INTEREST | $1,233,198 |
| TENANTS DEPOSITS | $23,583 |
| ACCOUNTS PAYABLE-AFFILIATES | $23,060,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $53,321,923 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE BOARD-DESIGNATED AND GENERAL ENDOWMENTS ARE USED FOR GENERAL HOSPITAL SUPPORT. THE BERNIER ENDOWMENT IS USED FOR STAFF CONTINUING EDUCATION. THE ERKKILA ENDOWMENT IS USED FOR HEALTH AND HUMAN PERFORMANCE RESEARCH AND REHABILITATION. THE MULLINS SCHOLARSHIP ENDOWMENT IS USED TO SUPPORT EDUCATIONAL SCHOLARSHIPS. THE PASTEGA HOUSE ENDOWMENT IS USED TO HELP UNDERWRITE THE OPERATING COSTS OF THE MARIO PASTEGA GUEST HOUSE. THE VRTISKA ENDOWMENT IS USED TO SUPPORT THE HOSPITAL'S LABORATORY FOR EDUCATIONAL PURPOSES. THE WISH ENDOWMENT IS USED FOR HOSPITAL-BASED PROGRAMS SUPPORTING WOMEN'S AND CHILDREN'S HEALTH. THE HALL ENDOWMENT IS USED TO PROVIDE GRADUATE MEDICAL EDUCATIONAL OPPORTUNITIES IN THE AREA OF PRIMARY AND INTERNAL MEDICINE. |
| PART X, LINE 2: | FOOTNOTE DISCLOSURE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE THE SHS' MANAGEMENT TO EVALUATE TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF SHS HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE NETWORK AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SHS IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. SHS' MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 16843 | PersonsServedCnt |
| Total Community Benefit Expns | $11,720,480 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,720,480 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03520 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 45629 | PersonsServedCnt |
| Total Community Benefit Expns | $45,715,108 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $35,196,555 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,518,553 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 29 | ActivitiesOrProgramsCnt |
| Persons Served | 62472 | PersonsServedCnt |
| Total Community Benefit Expns | $57,435,588 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $35,196,555 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,239,033 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06680 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 5288 | PersonsServedCnt |
| Total Community Benefit Expns | $631,270 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,075 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $630,195 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 1550 | PersonsServedCnt |
| Total Community Benefit Expns | $13,738,778 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,119,624 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,619,154 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02290 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 23 | ActivitiesOrProgramsCnt |
| Persons Served | 150403 | PersonsServedCnt |
| Total Community Benefit Expns | $50,760,301 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,805,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,954,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05700 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 9265 | PersonsServedCnt |
| Total Community Benefit Expns | $497,113 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $497,113 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 49 | ActivitiesOrProgramsCnt |
| Persons Served | 166506 | PersonsServedCnt |
| Total Community Benefit Expns | $65,627,462 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $37,926,167 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,701,295 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08330 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 78 | ActivitiesOrProgramsCnt |
| Persons Served | 228978 | PersonsServedCnt |
| Total Community Benefit Expns | $123,063,050 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $73,122,722 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $49,940,328 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 21 | PersonsServedCnt |
| Total Community Benefit Expns | $1,476 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,476 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 10 | PersonsServedCnt |
| Total Community Benefit Expns | $5,064 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,064 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 31 | PersonsServedCnt |
| Total Community Benefit Expns | $6,540 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,540 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,888,118 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,406,457 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $49,342,603 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $56,046,655 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,704,052 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (5 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| 1 CORVALLIS MED BLDGS LLC | ||
| REAL PROPERTY RENTAL | 0.54500 | 0.18500 |
| 2 HULL IMAGING LLC | ||
| IMAGING SERVICES | 0.60000 | 0.40000 |
| 3 SAMARITAN ENDOSCOPY CENTER | ||
| MEDICAL SERVICES | 0.66670 | 0.33330 |
| 4 CORVALLIS MRI A JV | ||
| IMAGING SERVICES | 0.50000 | 0.50000 |
| 5 CASCADE VIEW MEDICAL OFFICE BUILDING LLC | ||
| REAL PROPERTY RENTAL | 0.26300 | 0.73700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN HOSPITAL CORVALLIS | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 NW SAMARITAN DRIVE | AddressLine1 |
| City | CORVALLIS | City |
| State | OR | State |
| ZIP Code | 97330 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SAMHEALTH.ORG | WebsiteAddressTxt |
| State License | STATE LICEN | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN HOSPITAL CORVALLIS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.SAMHEALTH.ORG/COMMUNITYSUPPORT | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GOOD SAMARITAN HOSPITAL, CORVALLIS | PART V, SECTION B, LINE 3: THE STAFF FROM THE COMMUNITY HEALTH PROMOTION DEPARTMENT AND OTHER EMPLOYEES OF GOOD SAMARITAN HOSPITAL PARTICIPATED IN THE COMMUNITY-WIDE BENTON COUNTY COMMUNITY HEALTH ASSESSMENT PROCESS DURING 2012 AND 2013. THE OVERALL GSH COMMUNITY HEALTH NEEDS ASSESSMENT IS ADOPTED FROM THE BENTON COUNTY COMMUNITY HEALTH ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN; HOWEVER IN CONSULTATION WITH THE EPIDEMIOLOGIST FROM BENTON COUNTY HEALTH DEPARTMENT, ADDITIONAL INFORMATION WAS GATHERED THAT IS SPECIFIC TO THE GSH SERVICE AREA IS INCLUDED IN THE CHNA. PERSONS CONSULTED FOR THE HOSPITALS CHNA WERE BENTON COUNTY HEALTH DEPARTMENT, COMMUNITY OUTREACH INC., BENTON EAST LINN HEALTH CENTER, OREGON STATE UNIVERSITY, SAMARITAN HEALTH PLANS, WESTERN UNIVERSITY-COMP NORTHWEST, LINN-BENTON COMMUNITY COLLEGE, CORVALLIS SCHOOL DISTRICT, LINN-BENTON COUNTY HEALTH EQUITY ALLIANCE, OLD MILL CENTER FOR CHILDREN AND FAMILIES, PARENT ENHANCEMENT PROGRAM, STRENGTHENING RURAL FAMILIES, LOVE INC, CHURCH OF THE GOOD SAMARITAN, OREGON CASCADES WEST COUNCIL OF GOVERNMENTS, SAMARITAN INTERCOMMUNITY HEALTH NETWORK, DEPARTMENT OF HUMAN SERVICES, OREGON HEALTH AUTHORITY, COMMUNITY SERVICES CONSORTIUM, CORVALLIS CLINIC, MONROE SCHOOL DISTRICT, ALSEA SCHOOL DISTRICT, PHILOMATH SCHOOL DISTRICT, LINN-BENTON HISPANIC ADVISORY COUNCIL, BENTON COUNTY ORAL HEALTH COALITION AND COMMUNITY MEMBERS. |
| GOOD SAMARITAN HOSPITAL, CORVALLIS | PART V, SECTION B, LINE 5D: COPIES OF THE CHNA WERE EMAILED TO KEY COMMUNITY PARTNERS AND DISTRIBUTED DURING LOCAL COALITION MEETINGS. |
| GOOD SAMARITAN HOSPITAL, CORVALLIS | PART V, SECTION B, LINE 7: GSH HAS NOT DIRECTLY ADDRESSED EVERY NEED IDENTIFIED BY THE COMMUNITY BECAUSE THEY DO NOT FALL WITHIN THE SCOPE OF THE ORGANIZATION'S ROLE. THESE NEEDS INCLUDE GROUND WATER MANAGEMENT, ENVIRONMENTAL HAZARDS, AIR QUALITY AND WASTE MANAGEMENT. THESE NEEDS ARE BEING ADDRESSED BY THE APPROPRIATE LOCAL AND STATE AGENCIES. |
| GOOD SAMARITAN HOSPITAL, CORVALLIS | PART V, SECTION B, LINE 14G: REGISTRATION REFERS UNINSURED AND OR LOW INCOME PATIENTS TO THE ONSITE PATIENT FINANCIAL ADVOCATE AND A THIRD PARTY VENDOR WHO CONTACTS THE PATIENTS TO ASSESS THEIR FINANCIAL STATUS AND NEEDS. |
| PART V, SECTION B, LINE 14A: | THE ORGANIZATION'S WEBSITE PROVIDES INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE, INCLUDING FREE AND DISCOUNTED CARE, ALONG WITH CONTACT INFORMATION FOR PATIENTS TO BE ABLE TO APPLY FOR FINANCIAL ASSISTANCE. |
| PART V, SECTION B, LINE 20D: | THE MAXIMUM AMOUNT CHARGED BY THE HOSPITAL FACILITY TO FAP-ELIGIBLE INDIVIDUALS IS SET TO BE LESS THAN THE AVERAGE OF ALL NEGOTIATED COMMERCIAL INSURANCE RATES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 33 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (33 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| SAMARITAN REGIONAL CANCER CENTER | ||||
| 501 NW ELKS DR | CORVALLIS | OR | 97330 | RADIATION ONCOLOGY |
| SAMARITAN ORTHOPEDICS CLINIC | ||||
| 3620 NW SAMARITAN DR STE 202 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN HEART & VASC - VASC SURGERY | ||||
| 3615 NW SAMARITAN DR STE 201 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN SURGICAL SPECIALISTS | ||||
| 3615 NW SAMARITAN DR STE 201 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN GYN & SURGICAL ASSOCIATES | ||||
| 400 NW WALNUT BLVD STE 300 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN INTERNAL MEDICINE | ||||
| 3521 NW SAMARITAN DR STE 201 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN NEUROSURGERY | ||||
| 3615 NW SAMARITAN DR STE 210 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN FAMILY MEDICINE | ||||
| 3517 NW SAMARITAN DR STE 201 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| MAMMOGRAPHY CLINIC | ||||
| 3615 NW SAMARITAN DR | CORVALLIS | OR | 97330 | MAMMOGRAPHY CLINIC |
| SAMARITAN KIDNEY SPECIALISTS | ||||
| 3615 NW SAMARITAN DR STE 203 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN PEDIATRICS | ||||
| 777 NW 9TH ST STE 320 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN URGENT CARE CENTER | ||||
| 5234 SW PHILOMATH BLVD | CORVALLIS | OR | 97333 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN RHEUMATOLOGY | ||||
| 3620 NW SAMARITAN DR STE 203 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN ENDOSCOPY CENTER | ||||
| 3509 NW SAMARITAN DR STE 201 | CORVALLIS | OR | 97330 | ENDOSCOPY CENTER |
| CORVALLIS MRI | ||||
| 3615 NW SAMARITAN DR STE 101 | CORVALLIS | OR | 97330 | IMAGING SERVICS |
| SAMARITAN OBSTETRICS & GYN | ||||
| 3640 NW SAMARITAN DR STE 270 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN MENTAL HEALTH - CORVALLIS | ||||
| 3509 NW SAMARITAN DR | CORVALLIS | OR | 97330 | MENTAL HEALTH SERVICES |
| SAMARITAN PLASTICRECON SURG - HAVARD | ||||
| 996 NW CIRCLE BLVD STE 103 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN HEMATOLOGY & ONCOLOGY | ||||
| 3640 NW SAMARITAN DR STE 161 | CORVALLIS | OR | 97330 | RADIATION ONCOLOGY |
| SAMARITAN ORTHOPEDICS - DR VELA | ||||
| 3620 NW SAMARITAN DR STE 201 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN MENTAL HEALTH - ALBANY | ||||
| 1052 SW 29TH ST | ALBANY | OR | 97321 | MENTAL HEALTH SERVICES |
| SAMARITAN INFECTIOUS DISEASE | ||||
| 3640 NW SAMARITAN DR STE 210 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN UROLOGY | ||||
| 990 NW CIRCLE BLVD STE 102 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN HAND THERAPY | ||||
| 3640 NW SAMARITAN DR | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| OUTPATIENT SURGERY | ||||
| 3620 NW SAMARITAN DR | CORVALLIS | OR | 97330 | AMBULATORY SURGERY |
| SAMARITAN BARIATRIC SURGERY | ||||
| 3517 NW SAMARITAN DR STE 100 | CORVALLIS | OR | 97330 | AMBULATORY SURGERY |
| SAMARITAN FAMILY MEDICINE SOUTHWEST | ||||
| 5234 SW PHILOMATH BLVD | CORVALLIS | OR | 97333 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN PHYSICAL REHAB - CORVALLIS | ||||
| 3580 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN OCC MED - ALBANY | ||||
| 2615 WILLETTA ST SW STE C2 | ALBANY | OR | 97321 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN OCC MED - LEBANON | ||||
| 100 MULLINS DRIVE STE B2 | LEBANON | OR | 97355 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAM OCC MED - CORVALLIS | ||||
| 5234 SW PHILOMATH BLVD STE B | CORVALLIS | OR | 97333 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN OB & GYN RESIDENT CLINIC | ||||
| 3517 NW SAMARITAN DR STE 202 | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
| SAMARITAN MENTAL HEALTH FAMILY CTR | ||||
| 3539 NW SAMARITAN DR | CORVALLIS | OR | 97330 | MEDICAL CLINIC - OUTPATIENT |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE FILING ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT TO THE STATE OF OREGON. IN ADDITION, THE PARENT ORGANIZATION, SAMARITAN HEALTH SERVICES (SHS) PROVIDES AN ANNUAL REPORT TO THE COMMUNITY THAT INCLUDES COMMUNITY BENEFIT REPORTING FOR THE SYSTEM AS A WHOLE. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN SCHEDULE H, PART I, LINE 7A AND 7B IS A COST-TO-CHARGE RATIO DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES FROM THE SCHEDULE H INSTRUCTIONS. FOR LINE 7G, A COMBINATION OF THE COST-TO-CHARGE RATIO AND COST ACCOUNTING SYSTEM CALCULATIONS IS USED SINCE NOT ALL SERVICES ARE TRACKED IN THE COST ACCOUNTING SYSTEM. |
| PART I, LINE 7G: | PHYSICIAN CLINICS MEETING THE DEFINITION OF SUBSIDIZED HEALTH SERVICES WERE INCLUDED IN THE REPORTING FOR LINE 7G. THE PORTION OF NET COMMUNITY BENEFIT EXPENSE RELATED TO THESE CLINICS IS $15,632,810. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | GSH PROVIDES SERVICES AND ACTIVITIES THAT ARE CLASSIFIED AS COMMUNITY BUILDING. THIS INCLUDES LEADING DISASTER PREPAREDNESS DRILLS WITH LOCAL AGENCIES AND STAFF PARTICIPATING IN ONE-ON-ONE MENTORING PROGRAMS AT A LOCAL SCHOOL. GSH ALSO PROVIDES OPPORTUNITIES FOR COMMUNITY MEMBERS TO OBTAIN TRAINING ON CIVIC AND CULTURAL ISSUES THAT IMPACT HEALTH. SOME OF THE TRAINING OPPORTUNITIES INCLUDED GRANT WRITING AND BOARD DEVELOPMENT. GSH STAFF SERVES ON MANY LOCAL COALITIONS AND BOARDS THAT PROMOTE THE HEALTH OF THE COMMUNITY. BOARD AFFILIATION INCLUDES, BUT IS NOT LIMITED TO, COMMUNITY OUTREACH INC., OLD MILL CENTER FOR CHILDREN AND FAMILIES AND THE UNITED WAY OF BENTON AND LINCOLN COUNTIES. ADDITIONALLY GSH STAFF SERVES ON THE OREGON HEALTH POLICY ADVISORY BOARD, THE OREGON HEALTH RESOURCES COMMISSION, THE MEDICAID ADVISORY COMMITTEE, THE OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS AND REGIONAL BOARDS THAT ADDRESS HEALTH CARE ISSUES. |
| PART III, LINE 4: | THE COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE (AT COST) ON LINE 2 OF PART III IS BASED ON THE FACILITY COST-TO-CHARGE RATIO, IN CONJUNCTION WITH WORKSHEET A FROM THE SCHEDULE H, PART III INSTRUCTIONS.LINE 3 REPRESENTS AN ESTIMATE OF THE AMOUNT OF COST INCLUDED IN LINE 2 (BAD DEBT EXPENSE AT COST) THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, BUT FOR WHOM THE ORGANIZATION WAS NOT ABLE TO OBTAIN SUFFICIENT INFORMATION TO MAKE A DETERMINATION. THE METHODOLOGY USED TO ESTIMATE THIS POTENTIAL CHARITY CARE COST IS BASED ON FINANCIAL ASSISTANCE APPLICATIONS DENIED DUE TO INCOMPLETE DOCUMENTATION, MULTIPLIED BY THE AVERAGE CHARITY CARE WRITE-OFF FOR APPROVED APPLICATIONS.GOOD SAMARITAN HOSPITAL (GSH) IS THE LARGEST OF FIVE HOSPITALS OF SAMARITAN HEALTH SERVICES (SHS). AS A NETWORK, SHS PREPARES ITS FINANCIAL STATEMENTS ON A CONSOLIDATED BASIS. BAD DEBT EXPENSE IS DESCRIBED IN FOOTNOTE 1(O) ENTITLED "PROVISION FOR BAD DEBTS AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS", FOUND ON PAGES 11 AND 12 OF THE 2013 SHS CONSOLIDATED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | TOTAL MEDICARE ALLOWABLE COSTS REPORTED ON PART III, SECTION B, LINE 6 IS CALCULATED BY UTILIZING WORKSHEET B IN THE SCHEDULE H INSTRUCTIONS IN CONJUNCTION WITH AMOUNTS TAKEN DIRECTLY FROM THE FILING ORGANIZATION'S MEDICARE COST REPORT (CALCULATED BASED ON A COST-TO-CHARGE RATIO). CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED, AS THESE PATIENTS TYPICALLY HAVE LOW OR FIXED INCOMES AND GOVERNMENT REIMBURSEMENT IS NOT SUFFICIENT TO COVER THE COSTS OF PROVIDING CARE FOR THESE PATIENTS. MEDICARE PATIENTS ARE A GROWING SEGMENT OF THE LOCAL POPULATION, AND MANY ARE BECOMING INCREASINGLY DEPENDENT ON OUR HOSPITAL AND NON-PROFIT AFFILIATES TO PROVIDE FOR THEIR CARE, ESPECIALLY AS OTHER FOR-PROFIT HEALTHCARE PROVIDERS IN THE COMMUNITY DISCONTINUE ACCEPTING MEDICARE PATIENTS.THE AMOUNT OF MEDICARE SHORTFALL SHOWN ON LINE 7 OF PART III, SECTION B, IS UNDERSTATED. THIS IS PRIMARILY DUE TO THE FACT THAT THE MEDICARE COST REPORT INCLUDES ACTIVITY FOR MEDICARE FEE-FOR-SERVICE PATIENTS BUT NOT MEDICARE MANAGED CARE PATIENTS. MEDICARE MANAGED CARE ACCOUNTS FOR ROUGHLY HALF OF OUR MEDICARE ACTIVITY. IN ADDITION, CERTAIN COSTS OF PROVIDING HEALTHCARE SERVICES, SUCH AS PHYSICIAN COMPENSATION, ARE NOT ALLOWABLE ON THE MEDICARE COST REPORTS. THEREFORE, THE AMOUNT OF MEDICARE SHORTFALL SHOWN ON LINE 7 IS SMALLER THAN THE SHORTFALL CALCULATION USING REVENUE AND COST DATA FOR ALL MEDICARE PATIENT ACTIVITY, AS FOLLOWS:NET REV RECEIVED FROM MEDICARE (ALL MEDICARE PATIENT PROGRAMS):85,345,008MEDICARE COSTS (BASED ON A COST-TO-CHARGE RATIO): 109,941,112UNPAID COST OF PROVIDING SERVICES TO ALL MEDICARE PATIENTS: (24,596,104) |
| PART III, LINE 9B: | PER HOSPITAL GUIDELINES, IF A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE PRIOR TO SENDING AN ACCOUNT TO COLLECTIONS, THE CHARITY WRITE-OFF IS PROCESSED AND NO COLLECTION ATTEMPT IS MADE. IF AN ACCOUNT IS ALREADY IN COLLECTIONS AND MEDICAID ELIGIBILITY IS DEEMED ACTIVE DURING THE ACCOUNT DATE OF SERVICE, NO FURTHER COLLECTION ATTEMPT WILL BE MADE. |
| PART VI, LINE 2: | GOOD SAMARITAN HOSPITAL (GSH) ACTIVELY PARTICIPATES IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY. IN CONJUNCTION WITH THE UNITED WAY OF BENTON COUNTY, THE CITY OF CORVALLIS, BENTON COUNTY HEALTH DEPARTMENT, BENTON COUNTY FEDERALLY QUALIFIED HEALTH CENTER, OREGON STATE UNIVERSITY, WESTERN UNIVERSITY-COMP NORTHWEST, AND OTHER COMMUNITY PARTNERS, GSH EMPLOYEES AND OTHER SAMARITAN HEALTH SERVICES STAFF COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR GSH. THIS PROCESS INCLUDED EXAMINING PRIMARY DATA COLLECTED THROUGH FOCUS GROUPS, COMMUNITY FORUMS AND PERSONAL INTERVIEWS WITH SEVERAL COMMUNITY MEMBERS FROM THROUGHOUT BENTON COUNTY. SECONDARY DATA WAS GATHERED FROM STATE AND LOCAL AGENCIES THAT ADDRESS HEALTH NEEDS OF CHILDREN, YOUTH AND FAMILIES. GSH USES THE CHNA AS THE FOUNDATION FOR THE COMMUNITY BENEFIT PLAN THAT OUTLINES GOALS AND OBJECTIVES AND SERVICES THAT EXPAND ACROSS THE SAMARITAN HEALTH SERVICES SYSTEM RESPONDING TO COMMUNITY NEEDS. |
| PART VI, LINE 3: | GSH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTH CARE SERVICES TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. IF QUALIFICATIONS ARE MET, PATIENTS' CARE MAY BE PROVIDED FREE OR AT A REDUCED COST. THE DETERMINATION IS BASED IN PART ON POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. ONCE A COMPLETED FINANCIAL QUESTIONNAIRE HAS BEEN SUBMITTED, INDIVIDUALS/FAMILIES AT OR BELOW 200 PERCENT OF THE ESTABLISHED FEDERAL POVERTY LEVEL (FPL) COULD BE ELIGIBLE TO RECEIVE FREE OR DISCOUNTED CARE (CHARITY CARE).THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND COMMUNITY MEMBERS BY PUBLISHING INFORMATION REGARDING ALL FINANCIAL ASSISTANCE OPTIONS ON ITS WEBSITE, IN ADDITION TO IN PERSON AT THE REGISTRATION AREA, AND THROUGH CLEARLY IDENTIFIED MATERIALS LOCATED IN THE REGISTRATION AREA. |
| PART VI, LINE 4: | GSH PRIMARILY SERVES THE RESIDENTS OF BENTON COUNTY. HOWEVER, RESIDENTS FROM THE ADJOINING COMMUNITIES OF LINCOLN AND LINN COUNTIES ARE ALSO SEEN AT GSH. WITH A TOTAL POPULATION OF 85,579 (U.S. CENSUS 2010), BENTON COUNTY IS DESIGNATED AS AN URBAN COUNTY. THE COUNTY INCLUDES THE CITIES OF CORVALLIS AND PHILOMATH AS WELL AS THE SMALL INCORPORATED TOWNSHIPS OF MONROE AND ADAIR VILLAGE. APPROXIMATELY 21% OF BENTON COUNTY RESIDENTS LIVE IN RURAL AREAS OF THE COUNTY. THE MEDIAN HOUSEHOLD INCOME FOR BENTON COUNTY IS $47,716, AND 21.0% OF THE RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL. AS OF DECEMBER 2013, THE OREGON EMPLOYMENT DEPARTMENT REPORTED A 5.4% UNEMPLOYMENT RATE FOR BENTON COUNTY. THE COUNTY HEALTH RANKINGS INDICATE THAT 15% OF BENTON COUNTY RESIDENTS ARE UNINSURED. PORTIONS OF BENTON COUNTY HAVE DESIGNATIONS OF MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ACCORDING TO THE HEALTH RESOURCES AND SERVICES ADMINISTRATION, WITH GSH BEING THE ONLY HOSPITAL LOCATED IN BENTON COUNTY. |
| PART VI, LINE 5: | GSH'S GOVERNING BOARD IS COMPRISED OF LOCAL-AREA RESIDENTS. THE MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT, MEANING THEY AND THEIR FAMILY MEMBERS ARE NOT EMPLOYEES OF GSH NOR DO THEY HAVE ANY SIGNIFICANT BUSINESS RELATIONSHIPS WITH GSH. GSH EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. GSH APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. GSH INVESTS IN UPDATING EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. GSH IS ACCREDITED FOR CONTINUING MEDICAL EDUCATION AND OFFERS WEEKLY PROGRAMS FOR AREA PHYSICIANS AND OTHER HEALTH PROFESSIONALS. THE CENTER FOR HEALTH RESEARCH AND QUALITY, A DEPARTMENT OF GSH'S PARENT COMPANY, SAMARITAN HEALTH SERVICES (SHS), PROVIDES ADMINISTRATIVE OVERSIGHT FOR HEALTH AND CLINICAL RESEARCH, QUALITY IMPROVEMENT PROJECTS AND STUDIES, AND OTHER SPONSORED ACTIVITIES FOR GSH AND ITS AFFILIATED HOSPITALS. |
| PART VI, LINE 6: | "BUILDING HEALTHIER COMMUNITIES TOGETHER" IS THE COMMITMENT OF, AND THE MOTIVATION FOR, SAMARITAN HEALTH SERVICES (SHS), A NETWORK OF OREGON HOSPITALS, PHYSICIANS, AND SENIOR CARE FACILITIES THAT SERVES THE HEALTH CARE NEEDS OF PEOPLE IN THE MID-WILLAMETTE VALLEY AND THE CENTRAL OREGON COAST.AS THE INDIVIDUAL ENTITIES OF SHS CAME TOGETHER TO BUILD HEALTHIER COMMUNITIES, THEY WERE DRAWN BY A SHARED MISSION "TO ENHANCE COMMUNITY HEALTH AND ACHIEVE HIGH VALUE THROUGH QUALITY SERVICES ACROSS THE CONTINUUM OF CARE." THAT MEANS SHS LOOKS CAREFULLY AT LOCAL HEALTH CARE NEEDS, AND IT GIVES THOUGHTFUL CONSIDERATION TO THE MOST EFFECTIVE WAYS TO MEET THOSE NEEDS. THE RESULT IS A RICH MIX OF LOCAL AND CENTRALIZED REGIONAL SERVICES WHICH PROVIDE HIGH VALUE AND EXCELLENT HEALTHCARE FOR PEOPLE AT ALL STAGES OF THEIR LIVES. SERVICES ARE PROVIDED TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY. THE COLLECTIVE VISION OF SHS IS TO SUCCESSFULLY OPERATE AS A VALUES-DRIVEN, CHURCH-RELATED ORGANIZATION GOVERNED BY A PARTNERSHIP OF COMMUNITY MEMBERS, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. SHS SEEKS TO LEAD COLLABORATIVE EFFORTS AMONG PROVIDERS, EMPLOYERS, HEALTH PLANS AND CONSUMERS WHO SHARE SIMILAR GOALS AND VALUES TO MEET THE CHALLENGES OF THE FUTURE.GSH IS THE FLAGSHIP HOSPITAL OF SHS. IT PRIMARILY SERVES RESIDENTS OF BENTON COUNTY. OTHER AFFILIATED HOSPITALS ARE SAMARITAN ALBANY GENERAL HOSPITAL AND SAMARITAN LEBANON COMMUNITY HOSPITAL, SERVING RESIDENTS OF LINN COUNTY, AND SAMARITAN NORTH LINCOLN HOSPITAL AND SAMARITAN PACIFIC COMMUNITIES HOSPITAL, SERVING RESIDENTS OF LINCOLN COUNTY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OR |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| COMMUNITY OUTREACH | |||||||
| 865 REIMAN AVENUE | CORVALLIS | OR | 97330 | 930602094 | 501(C)(3) | $116,779 | MEDICAL, DENTAL, MENTAL HEALTH CLINICS |
| OLD MILL CENTER | |||||||
| 1650 SW 45TH PLACE | CORVALLIS | OR | 97333 | 930722603 | 501(C)(3) | $26,400 | COUNSELING, MENTAL HEALTH, AND PARENT EDUCATION |
| ALBANY HELPING HANDS | |||||||
| PO BOX 2252 | ALBANY | OR | 97321 | 931244271 | 501(C)(3) | $7,800 | SUPPORT FOR HOMELESS PEOPLE |
| CENTER AGAINST RAPE & DOMESTIC VIOLENCE | |||||||
| PO BOX 914 | CORVALLIS | OR | 97339 | 930792125 | 501(C)(3) | $18,000 | TRANSITIONAL HOUSING SERVICES FOR DOMESTIC VIOLENCE SURVIVORS |
| BENTON COUNTY HEALTH DEPARTMENT | |||||||
| 530 NW 27TH ST | CORVALLIS | OR | 97330 | 936002285 | GOV'T | $35,000 | ORAL HEALTH SUPPORT |
| OSU FOUNDATION | |||||||
| 850 SW 35TH ST | CORVALLIS | OR | 97333 | 936022772 | 501(C)(3) | $10,000 | TO PROVIDE HEALTHY COOKING CLASSES FOR FAMILIES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|
| TRANSPORTATION | 387 | $24,277 | |||
| MEDICAL ASSISTANCE | 8 | $2,120 | BOOK | MEDICAL SUPPLIES | |
| SHELTER | 10 | $200 | |||
| MEALS FOR FAMILY MEMBERS OF PATIENTS | 1201 | $12,019 | BOOK | MEALS |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AGENCIES IN THE COMMUNITY ARE INVITED TO SUBMIT GRANT PROPOSALS THROUGH AN APPLICATION PROCESS. A COMMITTEE REVIEWS THE APPLICATIONS TO DETERMINE IF THE FUNDS REQUESTED WILL BE USED TO ADDRESS THE ORGANIZATION'S ESTABLISHED COMMUNITY HEALTH PRIORITIES, IDENTIFIED NEEDS, AND SUPPORTS THE ORGANIZATION'S MISSION. ONCE APPROVED AND FUNDED, AGENCIES MUST SUBMIT A COMPLETE ANNUAL REPORT DESCRIBING HOW THE FUNDS WERE USED, THE NUMBER OF CLIENTS SERVED, AND HOW OUTCOMES WERE ACHIEVED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN W JASPERSON | ||||||||||||||
| CEO/VP SOUTHERN CALIFORNIA OPS | $0 | $387,111 | $0 | $0 | $0 | $48,397 | $0 | $20,952 | $0 | $22,889 | $0 | $479,349 | $0 | $0 |
| LARRY A MULLINS DHA | ||||||||||||||
| CEO/CEO SHS | $0 | $600,887 | $0 | $75,000 | $0 | $516,932 | $0 | $246,627 | $0 | $24,104 | $0 | $1,463,550 | $0 | $226,688 |
| DANIEL B SMITH | ||||||||||||||
| VP FINANCE/CFO | $0 | $299,635 | $0 | $0 | $0 | $7,665 | $0 | $20,952 | $0 | $29,455 | $0 | $357,707 | $0 | $0 |
| BECKY PAPE | ||||||||||||||
| COO/CEO MVH | $0 | $261,299 | $0 | $20,000 | $0 | $30,364 | $0 | $20,952 | $0 | $29,282 | $0 | $361,897 | $0 | $0 |
| KATHRYN M HALE | ||||||||||||||
| VP NURSING | $176,780 | $0 | $0 | $0 | $14,380 | $0 | $14,484 | $0 | $19,837 | $0 | $225,481 | $0 | $0 | $0 |
| MICHAEL A MAY MD | ||||||||||||||
| VP SMH MEDICAL DIRECTOR | $227,331 | $0 | $0 | $0 | $6,355 | $0 | $19,430 | $0 | $23,327 | $0 | $276,443 | $0 | $0 | $0 |
| SCOTT WILSON | ||||||||||||||
| VP ANCILLARY & SUPPORT SERVICES | $151,548 | $0 | $0 | $0 | $3,829 | $0 | $11,222 | $0 | $25,300 | $0 | $191,899 | $0 | $0 | $0 |
| JAMES RYAN MD | ||||||||||||||
| PHYSICIAN | $555,659 | $0 | $99,960 | $0 | $486 | $0 | $20,952 | $0 | $29,491 | $0 | $706,548 | $0 | $0 | $0 |
| DONALD PENNINGTON DO | ||||||||||||||
| PHYSICIAN | $571,140 | $0 | $156,896 | $0 | $18,310 | $0 | $20,952 | $0 | $26,837 | $0 | $794,135 | $0 | $0 | $0 |
| TOSHIO NAGAMOTO MD | ||||||||||||||
| PHYSICIAN | $464,047 | $0 | $324,380 | $0 | $18,702 | $0 | $20,952 | $0 | $27,341 | $0 | $855,422 | $0 | $0 | $0 |
| RANDALL V BREAM MD | ||||||||||||||
| PHYSICIAN | $601,758 | $0 | $0 | $0 | $19,936 | $0 | $20,952 | $0 | $22,941 | $0 | $665,587 | $0 | $0 | $0 |
| LUIS VELA DO | ||||||||||||||
| PHYSICIAN | $891,166 | $0 | $0 | $0 | $1,242 | $0 | $20,952 | $0 | $29,279 | $0 | $942,639 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM/FITNESS FACILITY BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. UNDER THIS PROGRAM, EMPLOYEES MUST MEET MINIMUM USAGE REQUIREMENTS IN ORDER TO QUALIFY FOR ONGOING BENEFITS. IF AN EMPLOYEE PARTICIPATES AT A NON-SAMARITAN GYM, REIMBURSEMENT IS MADE FOR UP-FRONT FEES, AND THEN PERIODICALLY UPON COMPLETION OF AT LEAST 60 VISITS. REIMBURSEMENT DOES NOT EXCEED $300 PER YEAR AND IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES AND IS SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. ONE KEY EMPLOYEE RECEIVED THIS TAXABLE GYM BENEFIT IN 2013. IF AN EMPLOYEE PARTICIPATES AT A SAMARITAN FITNESS CENTER (SAMFIT), MEMBERSHIP IS FREE OF CHARGE (PROVIDED AS A NONTAXABLE FRINGE BENEFIT), BUT THE EMPLOYEE IS REQUIRED TO ATTEND THE GYM 50 TIMES DURING EACH PERIOD OF 6 CONSECUTIVE MONTHS TO MAINTAIN THIS BENEFIT. NO PERSONS LISTED IN PART VII THAT ARE EMPLOYED BY THE FILING ORGANIZATION UTILIZED THE SAMFIT BENEFIT DURING 2013. |
| PART I, LINE 3 | THE CHIEF EXECUTIVE OFFICER IS EMPLOYED AND PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION CONDUCTS A COMPENSATION ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. PERIODICALLY, THE RELATED ORGANIZATION WILL ALSO USE WRITTEN EMPLOYMENT CONTRACTS, FORM 990 OF OTHER ORGANIZATIONS, AND INDEPENDENT COMPENSATION CONSULTANTS TO DETERMINE THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. |
| PART I, LINE 4B | 4.B. THE ORGANIZATION MAINTAINS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. UNDER THIS PLAN, LARRY A. MULLINS, DHA, ACCRUED DEFERRED COMPENSATION BENEFITS DURING 2013. HE ALSO RECEIVED A PAYMENT IN 2013 FROM THIS PLAN, WHICH IS INCLUDED IN HIS 2013 COMPENSATION ON SCHEDULE J AND FORM 990. $226,688 OF THIS PAYMENT WAS ACCRUED IN PRIOR YEARS AND WAS ALSO INCLUDED IN COMPENSATION DISCLOSED IN PRIOR YEARS AS REQUIRED ON SCHEDULE J AND FORM 990. |
| PART I, LINE 5 | VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TANIA MAY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAM MBR, M. MAY | RelationshipDescriptionTxt |
| Transaction | $119,076 | TransactionAmt |
| Transaction | EMP BY ORG | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | GOOD SAMARITAN HOSPITAL CORVALLIS HAS A SOLE CORPORATE MEMBER, SAMARITAN HEALTH SERVICES, INC., WHICH IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | GOOD SAMARITAN HOSPITAL CORVALLIS ELECTS MEMBERS OF ITS BOARD OF DIRECTORS. THOSE ELECTED MEMBERS ARE THEN SUBMITTED TO THE SOLE CORPORATE MEMBER FOR APPROVAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE CORPORATE MEMBER HAS SEVERAL RESERVED POWERS OVER THE ORGANIZATION. THESE RESERVED POWERS INCLUDE, BUT ARE NOT LIMITED TO, APPROVAL AT CERTAIN THRESHOLD LEVELS: THE BORROWING OF FUNDS, MERGERS AND ACQUISITIONS, AND SALES OR TRANSFERS OF ASSETS. IN ADDITION, THE SOLE CORPORATE MEMBER MUST APPROVE ANY CHANGE IN THE MISSION OF THE ORGANIZATION, THE ANNUAL BUDGET, AND ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF THE SAMARITAN HEALTH SERVICES (SHS) AUDIT AND COMPLIANCE COMMITTEE PRIOR TO ITS FILING WITH THE IRS. SHS IS A 501(C)(3) CORPORATION AND IS THE SOLE MEMBER OF THE FILING ORGANIZATION. SHS'S CHIEF FINANCIAL OFFICER CONDUCTED THE FORM 990 REVIEW WITH THE COMMITTEE AND PROVIDED TIME FOR QUESTIONS FROM THE GROUP. A FORMAL REPORT OF THIS COMMITTEE HAS BEEN MADE TO THE FULL BOARD OF DIRECTORS OF SHS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBER CONFLICTS OF INTEREST: THE MEMBERS OF THE BOARD MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CORPORATE COMPLIANCE OFFICER. IF A CONFLICT IS DISCLOSED THAT COULD PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THIS IS EVALUATED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES (SHS) BOARD OF DIRECTORS TO DETERMINE WHETHER THE MEMBER SHOULD CONTINUE TO SERVE ON THE BOARD. IF A CONFLICT IS DISCLOSED THAT DOES NOT PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THE CONFLICT IS MANAGED THROUGH A PROCESS SET FORTH IN THE ORGANIZATION'S BYLAWS. THE BYLAWS PROHIBIT ANY BOARD MEMBER FROM VOTING ON AN ACTION WHERE AN INDIVIDUAL MEMBER HAS A CONFLICT OF INTEREST. EMPLOYEE CONFLICTS OF INTEREST: THE SHS CODE OF ETHICS AND CONDUCT POLICY REQUIRES THAT ALL SHS EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST. THROUGH THE HUMAN RESOURCES SOFTWARE, PERFORMANCE MANAGER, THE DISCLOSURE REQUIREMENT NOTICE IS ASSIGNED TO ALL EMPLOYEES AND BY YEAR END ALL TASKS ARE TO BE COMPLETED. IF THERE IS A PERCEIVED CONFLICT OF INTEREST IT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, LEGAL COUNSEL AND/OR SENIOR MANAGEMENT. ACTUAL CONFLICTS OF INTEREST ARE REVIEWED AND DISCUSSED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE OF SAMARITAN HEALTH SERVICES, INC. ANNUALLY ENGAGES AN INDEPENDENT CONSULTANT TO ASSIST IT IN PROVIDING COMPARABLE MARKET DATA FOR THE CEO/CEO SHS. THIS ANALYSIS INCLUDES REGIONAL AND NATIONAL DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THIS INFORMATION IS USED BY THE COMPENSATION COMMITTEE IN ITS DELIBERATIONS REGARDING THE CEO/CEO SHS' COMPENSATION WHICH IS DOCUMENTED IN THE COMMITTEE'S MINUTES. SAMARITAN HEALTH SERVICES (SHS) USES PUBLICLY AVAILABLE INFORMATION TO DETERMINE THE COMPENSATION FOR THE CEO/VP SOUTHERN CALIFORNIA OPS. SHS CONSULTS WITH AN INDEPENDENT CONSULTANT AS TO THE REASONABLENESS OF THIS DATA TO ENSURE THAT THE COMPENSATION IS REASONABLE AS COMPARED TO SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. PHYSICIAN EMPLOYEE COMPENSATION, INCLUDING PHYSICIANS WHO ARE BOARD MEMBERS, IS REVIEWED AT LEAST ANNUALLY BY SENIOR MANAGEMENT. THIS REVIEW INCLUDES COMPARISON WITH PUBLISHED PHYSICIAN COMPENSATION STUDIES. FOR ALL OTHER EMPLOYEES, THE ORGANIZATION PERFORMS AN ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. SYSTEM-WIDE SUMMARIZED DATA IS ALSO PROVIDED IN THE ANNUAL REPORT TO THE COMMUNITY. THIS REPORT IS MADE AVAILABLE IN ALL KIOSKS AND HIGH-TRAFFIC AREAS OF ALL HOSPITALS AND PHYSICIAN CLINICS, AS WELL AS COMMUNITY PLACES SUCH AS THE PUBLIC LIBRARY. IT IS ALSO DISTRIBUTED TO THE BOARDS OF DIRECTORS AND DIRECTLY MAILED TO DONORS AND NEW RESIDENTS IN THE COMMUNITY. ADDITIONALLY, THE REPORT IS MADE AVAILABLE AT ALL EVENTS, COMMUNITY OUTREACH PROJECTS, AND SCREENINGS ATTENDED THROUGHOUT THE YEAR. GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | DISTRIBUTIONS TO MINORITY INTEREST CONSOLIDATED JVS -1,002,065. INCREASE IN MINIMUM PENSION LIABILITY 16,934,329. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALBANY GENERAL HOSPITAL | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930110095 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | 0 | |
| ALBANY GENERAL HOSPITAL FOUNDATION | |||||||||||
| 1046 SIXTH AVENUE SW | ALBANY | OR | 97321 | 930712890 | TO SUPPORT ALBANY GENERAL HOSPITAL | OR | 501(C)(3) | 7 | ALBANY GENERAL HOSPITAL | 0 | |
| FIRSTCARE HEALTH FOUNDATION | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930900124 | TO SUPPORT AFFILIATED EXEMPT ENTITIES | OR | 501(C)(3) | 11B, II | SAMARITAN HEALTH SERVICES | 0 | |
| FIRSTCARE MEDICAL FOUNDATION | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930932697 | FUTURE CHARITABLE HEALTHCARE INITIATIVES (NO CURRENT YEAR ACTIVITY) | OR | 501(C)(3) | 9 | SAMARITAN HEALTH SERVICES | 0 | |
| GOOD SAMARITAN HOSPITAL AUXILIARY | |||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 973393000 | 936024034 | TO SUPPORT GOOD SAMARITAN HOSPITAL | OR | 501(C)(3) | 11D, III-O | 0 | N/A | |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||||||||
| PO BOX 1068 | CORVALLIS | OR | 97339 | 237252406 | TO SUPPORT GOOD SAMARITAN HOSPITAL | OR | 501(C)(3) | 7 | GOOD SAMARITAN HOSPITAL | Yes (1) | |
| INTERCOMMUNITY HEALTH PLANS INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 931124326 | SERVE OREGON HEALTH PLAN FOR MEDICAID | OR | 501(C)(4) | N/A | SAMARITAN HEALTH SERVICES | 0 | |
| LEBANON COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| PO BOX 739 | LEBANON | OR | 97355 | 931260080 | TO SUPPORT LEBANON COMMUNITY HOSPITAL | OR | 501(C)(3) | 7 | MID-VALLEY HEALTHCARE INC | 0 | |
| MID-VALLEY HEALTHCARE INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930396847 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | 0 | |
| PARADIGM INDEMNITY CORPORATION | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 731668317 | PURE NON-PROFIT CAPTIVE INSURANCE COMPANY | HI | 501(C)(3) | 11A, I | SAMARITAN HEALTH SERVICES | 0 | |
| SAMARITAN HEALTH SERVICES INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930951989 | PROVIDE HEALTHCARE SUPPORT SERVICES | OR | 501(C)(3) | 11C, III-FI | 0 | N/A | |
| SAMARITAN NORTH LINCOLN HOSPITAL | |||||||||||
| 3043 NE 28TH STREET | LINCOLN CITY | OR | 97367 | 931305493 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | 0 | |
| SAMARITAN PACIFIC HEALTH SERVICES | |||||||||||
| 930 SW ABBEY STREET | NEWPORT | OR | 97365 | 931329784 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | 0 | |
| SAMARITAN SENIOR CARE INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 931245534 | FUTURE CHARITABLE HEALTHCARE INITIATIVES (NO CURRENT YEAR ACTIVITY) | OR | 501(C)(3) | 9 | SAMARITAN HEALTH SERVICES | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SAMARITAN ENDOSCOPY CENTER LLC | ||||||||||||||
| 3600 NW SAMARITAN DR | CORVALLIS | OR | 97330 | 202860067 | MEDICAL SERVICES | OR | GOOD SAMARITAN HOSPITAL | RELATED | $322,861 | $656,523 | 0 | Yes (1) | 0.66660 | |
| CORVALLIS MEDICAL BUILDINGS LLC | ||||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 931257913 | REAL ESTATE RENTAL | OR | GOOD SAMARITAN HOSPITAL | EXCLUDED | $77,430 | $1,261,091 | 0 | Yes (1) | 0.54500 | |
| EAST LINN MRI LLC | ||||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 320229399 | IMAGING | OR | N/A | |||||||
| HULL IMAGING LLC | ||||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 203255479 | IMAGING | OR | GOOD SAMARITAN HOSPITAL | RELATED | $917,344 | $33,443 | 0 | Yes (1) | 0.60000 | |
| CORVALLIS MRI A JOINT VENTURE | ||||||||||||||
| 3615 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 930949704 | IMAGING | OR | GOOD SAMARITAN HOSPITAL | RELATED | $331,676 | $253,762 | 0 | Yes (1) | 0.50000 | |
| MID-VALLEY MEDICAL PROPERTIES ASSOC LLC | ||||||||||||||
| 1046 SIXTH AVE SW | ALBANY | OR | 97321 | 300508747 | REAL ESTATE RENTAL | OR | N/A | |||||||
| MID-VALLEY MEDICAL BUILDINGS LLC | ||||||||||||||
| PO BOX 557 | LEBANON | OR | 97355 | 931126353 | REAL ESTATE RENTAL | OR | N/A | |||||||
| NORTHWEST MEDICAL ISOTOPES LLC | ||||||||||||||
| 815 NW 9TH ST STE 256 | CORVALLIS | OR | 97330 | 273007752 | RESEARCH | OR | N/A | |||||||
| 2750 HARRISON BLVD LLC | ||||||||||||||
| 413 SW 13TH AVE STE 300 | PORTLAND | OR | 97205 | 274665571 | REAL ESTATE RENTAL | OR | N/A | |||||||
| CASCADE VIEW MEDICAL OFFICE BUILDING LLC | ||||||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 300658805 | REAL ESTATE RENTAL | OR | GOOD SAMARITAN HOSPITAL | EXCLUDED | $3,713 | $1,672,708 | 0 | Yes (1) | 0.26300 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN HEALTH PLANS INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 NW SAMARITAN DRIVE | AddressLine1 |
| City | CORVALLIS | City |
| State | OR | State |
| ZIP Code | 97330 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930860860 | EIN |
| Primary Activities | HEALTH INSURANCE CARRIER FOR THE COMMUNITY | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| INTERCOMMUNITY HEALTH PLANS INC | ||
| L | $12,998,559 | COST |
| SAMARITAN ENDOSCOPY CENTER LLC | ||
| A | $341,233 | COST |
| SAMARITAN ENDOSCOPY CENTER LLC | ||
| O | $119,350 | COST |
| SAMARITAN ENDOSCOPY CENTER LLC | ||
| P | $119,350 | COST |
| SAMARITAN ENDOSCOPY CENTER LLC | ||
| S | $437,931 | COST |
| CORVALLIS MEDICAL BUILDINGS LLC | ||
| A | $50,347 | COST |
| CORVALLIS MEDICAL BUILDINGS LLC | ||
| K | $429,138 | COST |
| HULL IMAGING LLC | ||
| A | $80,087 | COST |
| HULL IMAGING LLC | ||
| O | $636,887 | COST |
| HULL IMAGING LLC | ||
| S | $921,000 | COST |
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