SALEM HEALTH FOUNDATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SALEM HEALTH FOUNDATION (EIN 23-7002687)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-11
- IRS object ID
- 201442239349302169
- Schema version
- 2012v2.1
- 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 G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-11T17:13:19-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930623286 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AKT LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237002687 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SALE | NameControl |
| Phone | 5035615576 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 890 OAK STREET SE | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARTIN A MORRIS | Name |
| Title | VP & CHIEF DEVELOPMENT OFFICER | Title |
| Phone | 5035615576 | Phone |
| Date Signed | 2014-08-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOYLYN M ANKENEY CPA | Name |
| PTIN | P00366587 | PTIN |
| Phone | 5036204489 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARTIN A MORRIS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 890 OAK STREET SE | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2344010 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SALEMHOSPITAL.ORG/FOUNDATION | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1968 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | DEDICATED TO RAISING, MANAGING AND DISTRIBUTING FUNDS TO HELP SALEM HOSPITAL ACHIEVE ITS MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY IT SERVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 14 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 961218 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 894250 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 633227 | InvestmentIncomePriorYear |
| Investment Income Current Year | 146436 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 60618 | OtherRevenuePriorYear |
| Other Revenue Current Year | 48637 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1655063 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1089323 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1276377 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1317967 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 16908 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 20977 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 25593 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 377763 | OtherExpensePriorYear |
| Other Expenses Current Year | 783492 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1671048 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2122436 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -15985 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1033113 | RevenuesLessExpensesCY |
| Total Assets BOY | 9036981 | TotalAssetsBOY |
| Total Assets EOY | 8190828 | TotalAssetsEOY |
| Total Liabilities BOY | 551185 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 40903 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8485796 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8149925 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE SALEM HOSPITAL FOUNDATION IS DEDICATED TO RAISING, MANAGING AND DISTRIBUTING FUNDS TO HELP SALEM HOSPITAL ACHIEVE ITS MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY IT SERVES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 155932 | Expense |
| Grants | 155932 | Grants |
| Description | SCHOLARSHIPS: NURSING, MEDICAL SCHOOL AND OTHER HEALTHCARE PROGRAMS. RECIPIENTS OF HEALTH CARE RELATED ACADEMIC SCHOLARSHIPS AND THE AMOUNTS OF THE AWARDS ARE DETERMINED BY ANALYSES OF THE CANDIDATES' QUALIFICATIONS, SCHOLARSHIP AWARDS ALREADY AWARDED TO THEM FOR THE YEAR BY OTHER ORGANIZATIONS, AND THE COSTS OF THE SPECIFIC SCHOOLS THE VARIOUS CANDIDATES WISH TO ATTEND. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1037536 | Expense |
| Grants | 1037536 | Grants |
| Description | PROPOSALS TO FUND CAPITAL EQUIPMENT AND MEDICALLY-RELATED ACTIVITIES AT SALEM HOSPITAL ARE RECEIVED AND REVIEWED BY THE FOUNDATION'S CHIEF DEVELOPMENT OFFICER. PROPOSALS ARE FORWARDED TO THE FOUNDATION'S BOARD OF DIRECTORS FOR FURTHER REVIEW AND APPROVAL IF THEY ARE CONSIDERED TO BE CONSISTENT WITH THE FOUNDATION'S ARTICLES OF INCORPORATION, STATING THAT ITS FUNDS ARE TO BE USED FOR HEALTH CARE, CHARITABLE, AND SCIENTIFIC PURPOSES, AND FOR MEDICAL AND SCIENTIFIC EDUCATION AND RESEARCH FOR THE USE AND BENEFIT OF SALEM HOSPITAL. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 124499 | Expense |
| Grants | 124499 | Grants |
| Description | CERTAIN RESTRICTED FUNDS HAVE BEEN CREATED AND ARE USED FOR THE PURPOSE ASSISTING DIABETES AND CANCER PATIENTS WITH THE COSTS OF THEIR EDUCATIONAL, SUPPLY AND OTHER CARE-RELATED EXPENSES. IN ADDITION, FUNDS ARE DISTRIBUTED TO ASSIST LOW INCOME INDIVIDUALS MEDICAL REQUIREMENTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 1317967 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 1 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5035611200 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 890 OAK STREET SE | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| KATHY GORDON | ||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| MARI BAILEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| GARTH BRANDAW | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MICHAEL DELK | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BARBARA FURER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JIM GRIGGS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BARBARA HALSEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BUD PIERCE MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROBERT PONEC MD | ||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| ALEX CASEBEER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LARRY GOODREAU | ||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| ERIC FISKUM | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RAGHU KAMINENI MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CARL VISINTAINER | ||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | |
| MARTIN MORRIS | ||||||
| CHIEF DEVELOP OFFICER/VP C | 40.00 | X | 0 | 264532 | 57077 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 264532 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 57077 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 8200 | FundraisingEvents |
| All Other Contributions | 886050 | AllOtherContributions |
| Total Contributions | 894250 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 130095 | TotalRevenueColumn |
| Exclusion | $130,095 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1250000 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1233659 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 16341 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16341 | TotalRevenueColumn |
| Exclusion | $16,341 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 69665 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 8200 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 21028 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 48637 | TotalRevenueColumn |
| Exclusion | $48,637 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1089323 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $195,073 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1037536 | Total |
| Program Services | 1037536 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 280431 | Total |
| Program Services | 280431 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1198 | Total |
| Management And General | 1198 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17800 | Total |
| Management And General | 17800 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20977 | Total |
| Fundraising | 20977 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21300 | Total |
| Management And General | 21300 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4616 | Total |
| Fundraising | 4616 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13322 | Total |
| Management And General | 13322 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58 | Total |
| Management And General | 58 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1224 | Total |
| Management And General | 1224 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral |
|---|---|---|
| MANAGEMENT SERVICES | 695854 | 695854 |
| MISCELLANEOUS | 20313 | 20313 |
| SOFTWARE/DATA PROCESS | 3705 | 3705 |
| BANK FEES | 2520 | 2520 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1582 | Total |
| Management And General | 1582 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2122436 | Total |
| Program Services | 1317967 | ProgramServices |
| Management And General | 778876 | ManagementAndGeneral |
| Fundraising | 25593 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 743801 | BOY |
| EOY | 306798 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1410000 | LandBuildingsEquipmentBasis |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1410000 | BOY |
| EOY | 1410000 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6833741 | BOY |
| EOY | 6427248 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49439 | BOY |
| EOY | 46782 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9036981 | BOY |
| EOY | 8190828 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125 | BOY |
| EOY | 1000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 551060 | BOY |
| EOY | 39903 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 551185 | BOY |
| EOY | 40903 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3293704 | BOY |
| EOY | 2975856 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2931424 | BOY |
| EOY | 2908401 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2260668 | BOY |
| EOY | 2265668 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8485796 | BOY |
| EOY | 8149925 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9036981 | BOY |
| EOY | 8190828 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1033113 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 697242 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 934781 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1212534 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 809178 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 956318 | CurrentTaxYearMinus1Year |
| Current Tax Year | 885907 | CurrentTaxYear |
| Total | 4798718 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 934781 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1212534 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 809178 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 956318 | CurrentTaxYearMinus1Year |
| Current Tax Year | 885907 | CurrentTaxYear |
| Total | 4798718 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 1094749 | AmountsSubstContributorsTotal |
| Public Support Total170 | 3703969 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 70592 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 52561 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 61625 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 200330 | CurrentTaxYearMinus1Year |
| Current Tax Year | 130095 | CurrentTaxYear |
| Total | 515203 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 5313921 | TotalSupport |
| Public Support Pertcentage170 | 0.69700 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.63870 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2752853 | BeginningOfYearBalance |
| Contributions | 42410 | Contributions |
| Investment Earnings Or Losses | 281433 | InvestmentEarningsOrLosses |
| Other Expenditures | 329298 | OtherExpenditures |
| End Of Year Balance | 2747398 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2450432 | BeginningOfYearBalance |
| Contributions | 79019 | Contributions |
| Investment Earnings Or Losses | 324539 | InvestmentEarningsOrLosses |
| Other Expenditures | 101137 | OtherExpenditures |
| End Of Year Balance | 2752853 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2498792 | BeginningOfYearBalance |
| Contributions | 18333 | Contributions |
| Investment Earnings Or Losses | -33888 | InvestmentEarningsOrLosses |
| Other Expenditures | 32805 | OtherExpenditures |
| End Of Year Balance | 2450432 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2344770 | BeginningOfYearBalance |
| Contributions | 19335 | Contributions |
| Investment Earnings Or Losses | 167208 | InvestmentEarningsOrLosses |
| Other Expenditures | 32521 | OtherExpenditures |
| End Of Year Balance | 2498792 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2285949 | BeginningOfYearBalance |
| Contributions | 31343 | Contributions |
| Investment Earnings Or Losses | 50166 | InvestmentEarningsOrLosses |
| Other Expenditures | 22688 | OtherExpenditures |
| End Of Year Balance | 2344770 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.82000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.18000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1410000 | InvestmentCostOrOtherBasis |
| Book Value | 1410000 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1410000 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO SALEM HOSPITAL | Description |
| Amount | $39,903 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 39903 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 2248432 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 697242 | NetUnrealizedGainsInvestments |
| Other Revenues | 461867 | OtherRevenues |
| Revenue Not Rptd F990 | 1159109 | RevenueNotRptdF990 |
| Revenue Subtotal | 1089323 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1089323 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2143464 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 21028 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 21028 | ExpensesNotRptdF990 |
| Expenses Subtotal | 2122436 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 2122436 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | SALEM HOSPITAL FOUNDATION HOLDS ENDOWMENT FUNDS FOR THE BENEFIT OF SALEM HOSPITAL AND FOR USE TOWARDS THE FOUNDATION'S MISSION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES NETTED WITH REVENUE 21,028. ASSETS RELEASED FROM RESTRICTION INCLUDED IN REVENUE 440,839. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES NETTED WITH REVENUE 21,028. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | 1 | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
Name Of Organization NameOfOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANCED MARKETING | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 THIELMAN DRIVE | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | DIRECT MAIL SOLICITATION | Activity |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFunds |
| Gross Receipts | 8505 | GrossReceipts |
| Amount Retained By Contractor | 15127 | AmountRetainedByContractor |
| Net To Organization | 8505 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 8505 | TotalGrossReceipts |
| Total Retained By Contractors | 15127 | TotalRetainedByContractors |
| Total Net To Organization | 8505 | TotalNetToOrganization |
| Licensed States | OR | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 77865 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 8200 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 69665 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 21028 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 77865 | GrossReceiptsTotal |
| Charitable Contributions Total | 8200 | CharitableContributionsTotal |
| Gross Revenue Total Events | 69665 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 21028 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 21028 | DirectExpenseSummaryEvents |
| Net Income Summary | 48637 | NetIncomeSummary |
Form990 Schedule G Part IV Form990ScheduleGPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF FUNDRAISING PAYMENTS | Identifier |
| Return Reference | SCHEDULE G, PART I, LINE 2B, COLUMN (V) | ReturnReference |
| Explanation | PAYMENT WAS FOR A 49,700 PIECE DIRECT MAIL SOLICITATION. 119 DONATIONS RECEIVED AS A RESULT OF MAILING, TOTAL CONTRIBUTIONS ATTRIBUTED TO MAILING WERE $8,505. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 890 OAK STREET SE | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 930579722 | EINOfRecipient |
| IRC Section | 503(C)(3) | IRCSection |
| Amount Of Cash Grant | 1037536 | AmountOfCashGrant |
| Method Of Valuation | N/A | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
| Purpose Of Grant | TO PAY FOR GENERAL EXPENSES AND CAPITAL EXPENDITURES. | PurposeOfGrant |
Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|
| SCHOLARSHIPS FOR STUDENTS LIVING IN MARION/POLK OR YAMHILL COUNTY WHO ARE PURSUING A CAREER IN HEALTHCARE. PAYMENTS MADE DIRECTLY TO THE COLLEGE(S) | 97 | 155932 | N/A | ||
| SMALL ONE-TIME CASH GRANTS ($150-$300) TO INDIGENT PATIENTS FOR EMERGENT NEEDS SUCH AS MEDICATION, UTILITIES, TRANSPORTATION, RENT, ETC | 41320 | N/A | |||
| NON-CASH SUPPORT OF INDIGENT PATIENTS OF SALEM HOSPITAL AND/OR COMMUNITY MEMBERS INCLUDING PROVIDING MEDICATION, TRANSPORTATION, MEDICAL EQUIPMENT, CAR SEATS AND OTHER SUPPORT. | ACTUAL COST | 83178 | MEDICATIONS, TRANSPORTATION, DURABLE MEDICAL EQUIPMENT, NON-MEDICAL SAFETY/PREVENTION ITEMS (CAR SEATS, EMERGENCY CALL SYSTEM, ETC), REQUIRED HEALTH COUNSELING, EDUCATION. |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: DECISIONS ON GRANTS TO SALEM HOSPITAL ARE MADE BY THE SALEM HOSPITAL FOUNDATION BOARD OF DIRECTORS. MINUTES OF THE MEETINGS OF THE FOUNDATION BOARD ARE SHARED WITH THE SALEM HEALTH BOARD OF TRUSTEES EACH MONTH. SCHOLARSHIPS ARE GRANTED TO COLLEGE STUDENTS THAT RESIDE IN MARION, POLK OR YAMHILL COUNTIES AND ARE PURSUING A HEALTHCARE RELATED CAREER. A SCHOLARSHIP COMMITTEE REVIEWS INDIVIDUAL APPLICATIONS AND RECOMMENDS TO THE BOARD RECIPIENT AWARDS FOR APPROVAL. SCHOLARSHIPS AWARDED ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTIONS FOR TUITION OR RELATED COSTS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARTIN MORRIS | NamePerson |
| Title | CHIEF DEVELOP OFFICER/VP C | Title |
| Base Compensation Filing Org | 0 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 250443 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 7224 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 6865 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 35089 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 21988 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 0 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 321609 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 4B | MARTIN MORRIS RECEIVED DEFERRED COMPENSATION UNDER A 457(F) NONQUALIFIED PLAN. THIS COMPENSATION IS INCLUDED IN COMPENSATION REPORTED IN PART II UNDER DEFERRED COMPENSATION. THE TOTAL NONQUALIFIED PORTION REPORTED IS $16,339. | |
| PART III | COMPENSATION OF THE V.P. & CHIEF DEVELOPMENT OFFICER IS DETERMINED BY THE CEO OF SALEM HEALTH, IN CONJUNCTION WITH OTHER SALARY SURVEY OR PUBLIC INFORMATION AND INDEPENDENT CONSULTANTS TO ENSURE THE COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. COMPENSATION AND BENEFITS REPORTED FOR MARTIN MORRIS ON SCHEDULE J, LINE 1, (II) ARE PAID BY SALEM HOSPITAL. THE FOUNDATION HAS A MANAGEMENT AGREEMENT TO REIMBURSE SALEM HOSPITAL FOR A PORTION OF HIS COMPENSATION AND BENEFITS WHICH TOTALED $80,402. THIS AMOUNT IS INCLUDED ON FORM 990 PART IX; LINE 24A UNDER MANAGEMENT SERVICES. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S GOVERNING EXECUTIVE COMMITTEE REVIEWS THE IRS FORM 990 BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS THE SECRETARY SHALL SEND TO EACH PERSON WHO IS A TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE A COPY OF THE POLICY REGARDING CONFLICTS OF INTEREST, TOGETHER WITH A QUESTIONNAIRE INQUIRING AS TO CONFLICTS, TO BE COMPLETED AND RETURNED TO THE SECRETARY BY THE TRUSTEE, OFFICER OR COMMITTEE MEMBER PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF THE V.P. & CHIEF DEVELOPMENT OFFICER IS DETERMINED BY THE CEO OF SALEM HEALTH, IN CONJUNCTION WITH OTHER SALARY SURVEY OR PUBLIC INFORMATION AND INDEPENDENT CONSULTANTS TO ENSURE THE COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAMPSHIRE PROPERTIES LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 890 OAK STREET SE | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 870804582 | EIN |
| Primary Activities | REAL ESTATE HOLDING | PrimaryActivities |
| Legal Domicile State | OR | LegalDomicileState |
| Total Income | -6460 | TotalIncome |
| EOY Assets | 1456781 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SALEM HOSPITAL | |||||||||||
| 890 OAK STREET SE | SALEM | OR | 97301 | 930579722 | HOSPITAL | OR | 501(C)(3) | 3 | SALEM HEALTH | 0 | |
| SALEM HOSPITAL AUXILIARY | |||||||||||
| 890 OAK STREET SE | SALEM | OR | 97301 | 931081113 | SUPPORTS SALEM HOSPITAL | OR | 501(C)(3) | 9 | 0 | N/A | |
| SALEM HEALTH | |||||||||||
| 890 OAK STREET SE | SALEM | OR | 97301 | 930823471 | LEASES LAND TO SALEM HOSPITAL | OR | 501(C)(3) | 11 TYPE 1 | 0 | N/A | |
| WEST VALLEY HOSPITAL | |||||||||||
| 525 SOUTHEAST WASHINGTON STREET | DALLAS | OR | 97338 | 431960221 | HOSPITAL | OR | 501(C)(3) | 3 | SALEM HEALTH | 0 | |
| WEST VALLEY HOSPITAL FOUNDATION | |||||||||||
| 525 SOUTHEAST WASHINGTON STREET | DALLAS | OR | 97338 | 931298564 | SUPPORTS WEST VALLEY HOSPITAL | OR | 501(C)(3) | 11 TYPE 1 | SALEM HEALTH | 0 | |
| WILLAMETTE VALLEY INSURANCE COMPANY | |||||||||||
| 745 FORT STREET | HONOLULU | HI | 96813 | 201836190 | CAPTIVE INSURANCE | HI | 501(C)(3) | 11 TYPE 1 | SALEM HEALTH | 0 | |
| WILLAMETTE VALLEY PROFESSIONAL SERVICES | |||||||||||
| 890 OAK STREET SE | SALEM | OR | 97301 | 753175249 | BILLING SERVICE FOR SALEM HOSPITAL, WEST VALLEY HOSPITAL, & SALEM HEALTH | OR | 501(C)(3) | 3 | SALEM HEALTH | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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