2013-02-15T15:50:05-08:00 2012-03-31 990 2011-04-01 930618975 LEGACY MERIDIAN PARK HOSPITAL LEGA 5034155600 19300 SW 65TH AVENUE TUALATIN OR 97062 DAVID E EAGER 2013-02-15 2011 2016-03-07 17:11:31Z GEORGE J BROWN MD C/O 1919 NW LOVEJOY STREET PORTLAND OR 97209 178059330 false false X WWW.LEGACYHEALTH.ORG X 1973 OR Legacy Meridian Park Hospital (LMPH), established in 1973, is a community hospital in Tualatin, OR, south of Portland with 150 licensed beds. LMPH serves the needs of the fast growing communities of Tualatin, Tigard, Wilsonville, Sherwood, West Linn, and Lake Oswego. LMPH offers outpatient diagnostic, angiography, and MRI/MRA, a total joint, diagnostic and interventional cardiac cath, a nationally recognized stroke program, cancer treatment, intensive and intermediate care units, a family birth center, and pediatric and ambulatory care units in the emergency department. LMPH is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and ach 16 14 0 395 0 298820 232379 159780831 171157491 14502526 6491404 35910 35455 174618087 177916729 13422 8022 0 60267714 64269836 0 0 82252756 88317469 142533892 152595327 32084195 25321402 230259870 247060253 70484667 74524348 159775203 172535905 Legacy Meridian Park Hospital (LMPH), established in 1973, is a community hospital in Tualatin, OR, south of Portland with 150 licensed beds. LMPH serves the needs of the fast growing communities of Tualatin, Tigard, Wilsonville, Sherwood, West Linn, and Lake Oswego. LMPH offers outpatient diagnostic, angiography, and MRI/MRA, a total joint, diagnostic and interventional cardiac cath, a nationally recognized stroke program, cancer treatment, intensive and intermediate care units, a family birth center, and pediatric and ambulatory care units in the emergency department. LMPH is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and ach false false 114350408 8022 171157491 In support of its mission, LMPH voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. During fiscal year 2012, LMPH provided financial assistance on approximately 13,400 patient accounts (of which 19% received discounts totaling 100% of costs) and resulted in LMPH incurring roughly $6,431,800 in uncompensated costs associated with this program. In addition to charity care, LMPH provides services under various states' Medicaid programs for financially needy patients and Medicare beneficiaries programs for which the cost of treating these patients exceeds the government payments received. During fiscal year 2012, LMPH incurred approximately $2,390,780 and $10,467,900 in uncompensated costs attributable to Medicaid and Medicare programs, respectively. LMPH also provides a variety of other community benefit activities such as medical education, donations to other charitable entities, research, and other health improvement services, which totaled roughly $635,790 during fiscal year 2012.LMPH is part of Legacy, which collectively provided over $71 million, $89 million, $69 million, and $2 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2012. In addition, Legacy provided over $20 million in other community benefit activities during fiscal year 2012. 114350408 true true false true false false false false false true true true false false true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false false false false true true false false false true 0 0 false 0 false false false false false false false false false false false false 0 false false false false false false false false false false false X 16 14 false true false false true true true true true false false false true true true true true true true true false false OR X X DAVID E EAGER 5034155600 1919 NW LOVEJOY STREET PORTLAND OR 97209 DAVID E EAGER 40.00 X X 0 168289 9895 SCOTT H JOHNSON 40.00 X X 0 301044 40480 P CAMPBELL GRONER III 40.00 X X 0 469829 89076 GEORGE J BROWN MD 40.00 X X 0 1022154 225916 LESLIE ROOT MD 4.00 X 0 63953 0 DIANE PINNEY 4.00 X 0 0 0 SHERYL MANNING 4.00 X 0 0 0 JOHN W WINTER JR 4.00 X 0 0 0 STEPHEN NEWBERRY MD 3.00 X 2260 0 0 RT REV MICHAEL J HANLEY 3.00 X 0 0 0 CORLISS A MCKEEVER 3.00 X 0 0 0 DUANE C MCDOUGALL 3.00 X 0 0 0 RONALD S KING 4.00 X 0 0 0 JEFFREY S GORDON 5.00 X X 0 0 0 JEFFREY D FULLMAN MD 3.00 X 0 0 0 ROBERT L CORNIE 4.00 X 0 0 0 COLLEEN A CAIN 7.00 X X 0 0 0 CHRISTOPHER S THOMING MD 3.00 X 0 0 0 BISHOP DAVID BRAUER-RIEKE 3.00 X 0 0 0 GLEN LUTZ 40.00 X 0 317262 44518 MAUREEN BRADLEY 40.00 X 0 250593 35146 EVERETT NEWCOMB III 40.00 X 0 556780 95856 SONJA O STEVES 40.00 X 0 339446 82854 TRENT S GREEN 40.00 X 0 381436 74391 CAROL A BRADLEY 40.00 X 0 345387 72675 GEORGE A CIOFFI MD 40.00 X 0 380828 62698 ALLYSON D ANDERSON 40.00 X 299929 0 63309 SUSAN J ELLISON 40.00 X 160350 0 35893 JULIE B GOODWIN 40.00 X 137838 0 33231 CORY L HUOT 40.00 X 143838 0 36650 CAROL J PALMER 40.00 X 153547 0 30197 DEBORAH CONDY 40.00 X 136387 0 26813 ROBERT J PALLARI 0.00 X 0 6320533 28576 PAMELA VUKOVICH 0.00 X 0 1431516 -8976 1034149 12349050 1079198 52 true true false WAVE FORM SYSTEMS INC PO BOX 6989 PORTLAND OR 97208 MEDICAL SERVICES 233490 PACIFIC HEART ASSOCIATES 19260 SW 65TH AVE TUALATIN OR 97062 CONSULTANTS 391386 HEART SOUNDS INC PO BOX 6495 PORTLAND OR 97228 MEDICAL SERVICES 275141 EXECUTIVE HEALTH RESOURCES INC PO BOX 822688 PHILADELPHIA PA 191822688 CONSULTANTS 181451 BAUGH SKANSKA INC PO BOX 767 BEAVERTON OR 97075 CONSTRUCTION 2118902 10 232379 232379 PATIENT PROGRAM REV 380068094 380068094 CONTRACTUAL ALLOWANCE -193261210 -193261210 CHARITY CARE -16536231 -16536231 CAFE & GIFT SHOP 886838 886838 171157491 6634005 6634005 0 0 35455 35455 35455 35455 142601 -142601 -142601 -142601 0 0 0 0 177916729 170270653 7413697 8022 8022 0 0 0 365499 314724 50775 0 48994476 42188225 6806251 3582316 3084665 497651 7319309 6302520 1016789 4008236 3451417 556819 0 5100 5100 0 0 0 0 2446190 2446190 0 27740224 26907391 832833 0 0 427752 427752 106523 92777 13746 0 0 1908491 1662220 246271 0 8943126 7789108 1154018 2552748 2462281 90467 PROVIDER TAX 1667262 1667262 BAD DEBTS 7098061 7098061 CONTRACT SERVICES 8796408 8107534 688874 ADMINISTRATIVE SERVICES FEES 25981596 25981596 643988 340259 303729 152595327 114350408 38244919 0 420006 293817 0 0 19318286 23486551 0 0 10985 0 2885156 3016370 106910 84570 149099363 108752602 38627597 40346761 0 161825725 172766976 0 0 7065205 7065208 230259870 247060253 13275739 14701001 815231 57208928 59008116 70484667 74524348 X 159775203 172535905 159775203 172535905 230259870 247060253 X 25321402 -12560700 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false X 288019 288019 132307222 1204880310 132307222 1205168329 1000000 1000000 250000 250000 false 2000000 2000000 2000000 2000000 8000000 12000000 59359 263925 349418 288019 960721 500000 500000 500000 500000 2000000 3000000 1122505 150212 24327 172596 1124448 1068961 286728 101635 334819 1122505 830206 74541 260362 96148 1068961 0.96000 0.04000 false true true 153922 153922 73114936 53710443 19404493 1267104 1000665 266439 74366095 54041494 20324601 197306 197306 40346761 172766976 NONCURRENT WORKERS' COMP LIABILITY 361636 NONCURRENT PENSION LIABILITY 13343957 NONCURRENT ENVIRONMENTAL OBILGATION 195464 I/C AFFILIATE DEBT 45107059 59008116 177916729 152595327 25321402 -12560700 -12560700 12760702 177789000 203018 203018 177585982 330747 330747 177916729 152627000 262358 262358 152364642 230685 230685 152595327 Part XIII, Line 4b Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S ROUNDING $0 GIFT SHOP/AUXILIARY EXPENSE $60470 MEDICAL STAFF EXPENSE $170215 Part XIII, Line 2d Part XIII, Line 2d: Other expenses and losses per audited F/S FOUNDATION CONTRIBUTION $-84433 GAIN / LOSS OF SALE OF ASSETS $142601 PROGRAM SERVICE REVENUE RECLASS $203018 ROUNDING $1172 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S ROUNDING $1212 GIFT SHOP/AUXILIARY INCOME $38942 FOUNDATION CONTRIBUTION $84433 MEDICAL STAFF INCOME $200816 GAIN / LOSS OF SALE OF ASSETS $-142602 FOUNDATION CAPITAL CONTRIBUTION $147946 Part XII, Line 2d Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 PROGRAM SERVICE REVENUE RECLASS $203018 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY $ -6295711 TRANSFER TO AFFILIATES $ -6264989 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Meridian Park Medical Foundation (MPMF) maintains all charitable gifts including endowment funds for the benefit of LMPH and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator. true true X true X true X true true true false true true 6431802 6431802 0.04210 8363319 5972545 2390774 0.01570 14795121 5972545 8822576 0.05780 42318 6436 35882 0.00020 418414 418414 0.00270 181494 181494 0.00120 642226 6436 635790 0.00410 15437347 5978981 9458366 0.06190 false 7098061 4258837 25862429 33247700 -7385271 X true true 1 0 LEGACY MERIDIAN PARK HOSPITAL

19300 SW 65TH AVENUE TUALATIN OR 97062

X X X LEGACY MERIDIAN PARK HOSPITAL 1 true X X X X X X X X X true true true X false true true 200.0000 true 400.0000 true X X X X X X X true true X X X X X X true false X X X X true X false false Part VI - States Where Community Benefit Report Filed OR Part VI - Affilated Health Care System Roles and Promotion LMPH is a subsidiary of Legacy Health (Legacy). Legacy is an integrated health system based in Portland, Oregon and primarily operates five acute care hospitals and related services (e.g., physician practices, hospice, preferred provider network) in the four county metro area of Portland and SW Washington. The Legacy Board is comprised of community and business leaders as well as representatives of the medical staff. The LMPH medical staff is open, with physicians submitting credentialing information reviewed according to LMPH policies and standards. In 1998, the Legacy Health Board approved a $10 million Community Health Fund from operating revenue to address major community health issues. About $500,000 annually has been granted to community-based projects addressing racial and ethnic inequities and root causes. These dollars are in addition to the system's generous charitable contributions. The Community Health Fund has provided 33 grants since 1998 totaling nearly $6.2 million. In 2010, Legacy established the CLEAR/Health Literacy initiative. The ability of patients to both understand and act upon the medical information provided to them is critical to their health outcomes. Patients must use information to navigate the health system (complete insurance and government forms, sign consents, schedule appointments), manage diseases and acquire preventive screenings. Providers (defined as all staff interacting with or developing materials used by patients) are responsible for ensuring that patients can act on the information provided. Funded by the Community Health Fund in 2012, Legacy hosted the first Oregon and SW Washington Health Literacy Conference. 360 people from 69 organizations attended. Legacy is now the recognized leader in moving health literacy forward both in the health delivery system and broader community.Recognizing that education, employment and income inequities exist for communities of diversity, and that health professions are lacking in diversity, Legacy established the Youth Employment in Summer program in 1999. Annually, 13-15 African American, Hispanic and Native American youth receive paid summer employment in departments where they work with health professionals and earn college scholarships between $2,500 and $5,000 annually. Students must remain in school and pursued health careers in order to continue in the program. Some students remain in the program as long as seven years and graduated with degrees in a variety of healthcare fields. The vast majority of the students are the first in the families to go to college. In addition to the Community Health Fund, Legacy provided cash donations to local health and human service, education, economic development and civic organizations. Donations focus on organizations with year-round relationships through programs and board representation. A few examples include Community Action Organization of Washington County, Vision Action Network, Essential Health Clinic and the local schools. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Non-cash donations of resources include clinical and non-clinical services and items such as screenings and support services, internships, information and referral services and health fairs. Legacy's warehouse is located on Legacy Good Samaritan's campus and is open to nonprofit organizations to obtain surplus equipment and furniture. In addition, conference room space is made available to local nonprofits for Board and community meetings.Clinical staff at Legacy hospitals is involved with local communities through many child safety programs. In 1986, nurses in Emanuel Hospital's Level I Trauma Center developed the Trauma Nurses Talk Tough (TNTT) program. Taught by trauma and emergency medical professionals, the program reaches 36,000 people each year. The American Hospital Association awarded the TNTT program its NOVA Award. In addition, Legacy staff members conduct free education sessions to show parents how to properly install car seats. Last year, Legacy staff fit and sold more than 9,000 bicycle helmets for children at a nominal or no fee based on need. Legacy staff members also provide new parents with training to reduce the incidences of shaken baby syndrome and our in-house Safety Store sells child protection devices for the home at a nominal charge. Part VI - Community Information LMPH is located in Tualatin, Oregon and straddles the Clackamas and Washington County border. As a full-service hospital in the south metro area, the hospital's five mile primary service area includes the fast-growing communities of Tualatin, Tigard, Wilsonville, Sherwood, West Linn and Lake Oswego. The five mile radius is predicated on the assumption that this includes approximately 80 percent of the hospital's discharges. Primary service area boundaries extend from Highway 219 on the west to SW Wilsonville Rd on the south to just east of Highway 43 on the east and just north of SW Hall Blvd on the north. Zip codes for the five mile area include: 97034, 97035, 97036, 97062, 97068, 97070, 97140, 97223 and 97224. The Washington and Clackamas counties encompass residents far beyond the service area. Generally, the primary service data is not readily available, so the county information is utilized. Washington and Clackamas Counties had populations of 532,620 and 381,775 respectively in 2009. Recently, Legacy added two clinics located in Woodburn and Canby. While these communities are not within LMPH's five mile primary service area, the clinics are considered as part of LMPH's communities. Since there are only a few large employers located in the area, most residents commute to other cities for employment.In November 2010, the Portland State University (PSU) Population Research Center reported the Oregon metro area tri-county population at 1,644,535 residents; with Clark County, the four county area was 2,080,926. The growth rate for Clackamas County was 0.5 percent and 1.0 percent for Washington. The latter showed the greatest percent growth statewide. The population of the five mile primary service area was 226,068 in 2010.Median age in Oregon in 2009 was 38 years. Washington County had the youngest median age at 35 years and Clackamas the oldest at nearly 39 years. Consistent with median age, 12 percent of the Clackamas County population was 65 years and older compared to 9.0 percent in Washington County. The percent of population under five years ranged from 5.6 percent in Clackamas County to 7.5 percent in Washington County. Washington County has the largest percentage of Hispanics which may account for both the lower median age and larger percentage of children.In 2010 the LMPH primary service area was 81.9% non-Hispanic white, 8.8% Hispanic, 1.0% African American, 5.0% Asian, 2.5% bi-racial and 0.4% Native American. In comparison, Washington County in 2009 was 71.2 percent non-Hispanic white, 15.3 percent Hispanic, 8.7 percent Asian (the latter is the largest percent among all counties in the state), 2.1 percent African American, 1.0 percent Native American and 2.6 percent bi-racial and Clackamas was 84.6 percent non-Hispanic white, 7.6 percent Hispanic, 3.8 percent Asian, 1.1 percent African American, less than 1 percent Native American and 2.4 percent bi-racial. Hispanics are moving into the LMPH service area at a higher rate than any other group (more than doubling in numbers in the past 15 years). Additionally, they have a higher birth rate than other communities of color. The Hispanic population accounts for about one-fifth of the births in Oregon and Washington while they make up just one-tenth of the population. Between 1995 and 2004 the percentage of babies born to Hispanic mothers has increased to 67 percent. It is projected that communities of color will make up the majority of the Oregon population by 2040, and that 25 percent of the population will be Hispanic. The immigrant and refugee population is growing significantly in the region. Recent immigrants and refugees are more likely to be culturally and linguistically isolated. 22% of the population in Washington County speaks a language other than English at home as compared to 11% in Clackamas County. Spanish is the most common language spoken with Vietnamese and Chinese also prevalent. A small but increasing African refugee population has settled mid-Washington County and is distinct from the African American/Black population. Available data suggests that the African population is generally poorer than other communities.While still a small population relative to the entire metro area, specific geographic areas are experiencing significant growth in the Slavic population especially in the far southern metro area, south of the Clackamas County border in Woodburn. Slavs are counted in the non-Hispanic white population, but they have distinct cultural identity. Their socioeconomic indicators are generally lower than the other non-Hispanic white population.The LMPH primary service area is also served by Providence St. Vincent Medical Center, a tertiary hospital located just north of the primary service northern boundary. Community-based Providence Willamette Falls Hospital located in Clackamas County is beyond the primary service area, but serves some of the overlapping area. Located in far west Washington County is community-based Tuality Hospital. It is outside the service area, but in the same primary service area county. Kaiser Permanente has a strong presence with clinics and a hospital in Clackamas' Sunnyside area. Kaiser is also constructing a hospital in mid-Washington County.Southwest Clackamas County includes a Medically Underserved Area (MUA) which is beyond the primary service area. Clackamas County Health Department Clinics are FQHCs, but are located across the Willamette River in areas further from LMPH. Legacy Medical Group Clinic in Canby is a designated Rural Health Center. Legacy Laboratories donates services to Essential Health Clinic, a one volunteer staffed safety net clinic, located in Tigard. The area is also served by the Virginia Garcia Memorial Health Clinic is a community-based FQHC whose primary clinics are in mid and far west Washington County. A new volunteer staffed safety net clinic in Oregon City will open winter 2012. Legacy donated furniture and equipment to the school-based health center at Tigard High School. A local non-profit, Project Access NOW, links uninsured low income individuals to no-cost healthcare services. All of the health systems in the metro area are very involved with this program. Legacy Health provides cash donations, free administrative office space for Project Access NOW as well as clinical services.In FY 12, LMPH provided $6.4 million in charity care; total unreimbursed costs of care for people in need amounted to $19.0 million. Part VI - Patient Education of Eligibility for Assistance LMPH employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, LMPH's financial assistance program, and public assistance programs, such as Medicaid. The criteria for financial assistance under LMPH's program is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for medically necessary services provided. Specifically, the LMPH Financial Assistance Program provides an uninsured discount of 15% to patients who have resided within LMPH's primary service area for a period of six months, are uninsured for hospital care, and have a household income of less than $100,000 annually. Further discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level or roughly $92,200 for a family of four in Portland, Oregon. For patients whose household income is at or below 200% of the federal poverty level, a full subsidy is available. In addition to the household income criteria, the patients' qualified assets (e.g. 25% of household assets), and other catastrophic or economic circumstances are considered in determining eligibility. In addition to financial counselors and social workers, LMPH makes every effort to communicate its Financial Assistance Program to all patients. This includes signage in main admitting areas of each hospital and brochures explaining financial assistance in all patient care areas, as well as in appropriate languages. Financial counselors are available to assist patients in understanding and applying for available resources, including the LMPH Financial Assistance Program. LMPH's website also has information about the availability of financial assistance. LMPH offers financial assistance customer service Monday through Friday, as well as the availability of voice mail so patients can leave confidential, detailed messages during non-business hours. Finally all of Legacy's billing statements include information regarding the availability of financial assistance. If LMPH requires the use of a collection agency, those agencies are required to provide a telephone number that patients can call to request financial assistance.In 2010, Legacy Health established the CLEAR initiative. CLEAR stands for Communication, Literacy, Education and Achieve Results. CLEAR is becoming a part of Legacy's culture as nearly all departments have a direct impact on how we deliver patient care. CLEAR will be rolled out in four stages: awareness, education, practice and culture. The first stage focuses on building awareness, educating staff in health literacy and developing department action plans. The second stage will include continuing education and putting health literacy tools into consistent practice. In the third stage, CLEAR will be practiced within all departments and become a part of Legacy's culture. Quality, safety and cost are all affected by a patient's inability to understand medical instructions and to explain their symptoms/issues. Understanding health literacy is essential. Annual education is provided to all billing and admitting staff so they can be kept informed of and speak with knowledge about current financial assistance policies and options. LMPH provides copies of the latest policies in main admitting areas, as well as through newsletters and other publications. Part VI - Needs Assessment Senior leadership, in conjunction with the Board of Directors, continually assesses the needs of the communities it serves through a compilation of primary and secondary market research (qualitative and quantitative), medical staff input, reviewing national trends and practices, working with local foundations and funders regarding their assessments, and working with local community-based partners to understand their needs. The goal is to understand the needs and develop programs specific to the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of these assessments is the development of both long-term and fiscal year plans that are supported by a yearly budget that is proposed by staff and approved by the Board of Directors. During 2010, Legacy Health conducted a community needs assessment. The results of the assessment were available in July of 2011 and can be found at www.LegacyHealth.org. The region served by Legacy Meridian Park Hospital(LMPH), along with most of Oregon, is experiencing significant challenges in population growth, economic development, education and health care. Recognizing that social and economic determinants impact health, LMPH has been and will remain committed to addressing these issues to improve the health of all residents in the community, including equity among ethnically diverse populations. Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance The hospital facility used the Federal Poverty Guidelines to determine the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care. Discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level. A full subsidy is available for patients whose income is at or below 200% of the federal poverty level. Number of Hospital Faciltiy - 0 Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why Legacy Meridian Park did not address needs identified in the Community Needs Assessment for the reasons explained in the following, by need. These are included in the Community Needs Assessment and Implementation Strategies Plan.NEED: Mental Health: limited financial and labor resources prevent addressing as need.NEED: Early Childhood: limited financial and labor resources prevent addressing as need.NEED: Natural Environment: limited financial and labor resources prevent addressing as need.NEED: HIV/AIDS: limited financial and labor resources prevent addressing as need.NEED: Transgender Care: limited financial and labor resources prevent addressing as need.NEED: Autism: limited financial and labor resources prevent addressing as need Number of Hospital Faciltiy - 0 Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment The Community Needs Assessment was conducted in conjunction with the four other Legacy Health hospitals, i.e., Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center, Legacy Mount Hood Medical Center and Legacy Salmon Creek Medical Center. Number of Hospital Faciltiy - 0 Part V, Line 3 - Account Input from Person Who Represent the Community Input from persons who represent the community consisted of one on one personal interviews conducted by leadership with elected officials (state, county and city) and public sector (public health, human services), faith, business and community nonprofit organization members, including representatives of culturally, racially and ethnically diverse and low income communities. Interviewees were intentionally designated based on their direct involvement with organizations and/or issues in the service areas. The following lists 54 interviewees, by title and organization. Thomas D. Aschenbrener, President/CEO, Northwest Health FoundationMichael Balter, Executive Director, Boys and Girls Aid Society Carolyn Becic, Executive Director, Oregon Mentors Cindy Becker, Administrator, Clackamas County Health and Human ServicesSharon Brabenac, Development Director, YWCA of Greater PortlandThe Right Rev. David Brauer-Rieke, Bishop, Oregon Lutheran Synod ELCARachel Bristol, Executive Director, Oregon Food BankSam Brooks, Former President, Oregon Association for Minority EntrepreneursLisa Brown, Executive Director, Community Action Organization of WA CountyMargaret Carter, Deputy Director of Human Services, Oregon Department of Human ServicesGale Castillo, Executive Director, Hispanic Metropolitan ChamberRobin Christian, Executive Director, Children First for OregonRodney Cook, Director, Clackamas Office of Children and FamiliesCarlos Crespo, Director, Portland State University School of Community Health Marie Dahlstrom, Executive Director, Familias en AccionAndy Davidson, President/CEO, OAHHSMarty Davis, Publisher, Just OutChris DeMars, Program Officer, NW Health FoundationKevin Dowling, Program Manager, CARES NWErin Fair, Policy Director, Care OregonPietro Ferrari, Executive Director, HaciendaJeana Frazzini, Executive Director, Basic Rights OregonBruce Goldberg, MD, Director, Oregon Department of Human Services Guadalupe Guajardo, Senior Consultant, Nonprofit Association of Oregon Mary Lou Hennrich, Executive Director, Oregon Public Health InstituteDavid Leslie, Executive Director, Ecumenical Ministries of OregonHolden Leung, Executive Director, Asian Health and Service CenterMarc Levy, Executive Director, United Way of the Columbia WillametteSia Lindstrom, Sr. Deputy County Administrator, Washington CountyAdrienne Livingston, Executive Director, Black United FundCharles McGee II, President/CEO, Black Parent InitiativeAndrew McGough, Executive Director, Worksystems Inc.Corliss McKeever, President/CEO, African American Health CoalitionLinda Moholt, Executive Director, Tualatin Chamber of CommerceMary Monat, Executive Director, LifeWorks NW Vicki Nakashima, Executive Director, Partners in Diversity Sue Neal, Board Chair, Essential Health ClinicLinda Nilsen-Solares, Executive Director, Project Access NOWLou Ogden, Mayor, City of TualatinKathleen O'Leary, Public Health Division Manager, Washington County Health Department Carman Rubio, Executive Director, Latino NetworkRob Saxton, Superintendent, Tigard Tualatin School DistrictKim Scott, Executive Director, Trillium Family ServicesBill Thomas, Director, Washington County Commission on Children and FamiliesLynn Thompson, CEO, Big Brothers Big Sisters Columbia NorthwestTricia Tillman, Administrator, Oregon Multicultural Health and ServicesKarin Kelly Torregroza, Executive Director, Vision Action NetworkGreg Van Pelt, Chief Executive Oregon, Providence Health and Services Oregon RegionMaree Wacker, CEO, American Red Cross Oregon Trail ChapterLarry Wallack, DrPH, Dean, Portland State University College of Urban and Public Affairs,Catherine West, Executive Director, Tualatin Resource CenterJoyce White, Executive Director, Grantmakers of Oregon and SW Washington Wim Wievel, PhD, President, Portland State UniversityDavid Wynde, Vice President, US Bank Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Legacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $61,139,814 and $71,607,667 respectively. This results in a total Medicare shortfall of $10,467,853.Costing Methodology (Part III, Line 8).Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay. Part III, Line 4 - Bad Debt Expense The estimated amount of bad debt expenses attributable to charity care policy was calculated using the demographic profile of household income and average household size in the zip code areas around the hospital. 60% of Households in the LMPH service area would qualify for financial assistance with incomes under 400% of the Federal Poverty Guidelines.LMPH uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, LMPH must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information. Part I, Line 7 - Explanation of Costing Methodology Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay. true MEDICAL TEAMS INTERNATIONAL 14150 SW MILTON CT TIGARD OR 97224 930878944 0 8022 COST SUPPLIES FOR DISASTER ASSISTANCE 1 0 Grantmaker's Description of How Grants are Used Legacy reviews all organizations prior to donating cash or supplies to ensure their 501(c)(3) status. Legacy regularly donates supplies to Medical Teams International for disaster relief. Several Legacy medical staff members, volunteer for Medical Teams International. true true false false false true true false true true TRENT S GREEN 317755 18629 45052 44464 29927 455827 47142 SUSAN J ELLISON 155735 4746 -131 21302 14591 196243 SONJA O STEVES 282395 16556 40495 55319 27535 422300 40092 SCOTT H JOHNSON 271244 13216 16584 22178 18302 341524 16029 ROBERT J PALLARI 6320533 28576 6349109 2085123 PAMELA VUKOVICH 50944 1380572 -18321 9345 1422540 977138 P CAMPBELL GRONER III 348132 20541 101156 53296 35780 558905 92738 MAUREEN BRADLEY 231005 16597 2991 17226 17920 285739 JULIE B GOODWIN 137517 5178 -4857 13779 19452 171069 GLEN LUTZ 307008 7500 2754 17237 27281 361780 GEORGE J BROWN MD 827692 71740 122722 166329 59587 1248070 106707 GEORGE A CIOFFI MD 354917 20807 5104 33930 28768 443526 EVERETT NEWCOMB III 511302 31045 14433 65673 30183 652636 DEBORAH CONDY 123692 250 12445 16901 9912 163200 DAVID E EAGER 143310 25000 -21 9895 178184 CORY L HUOT 146663 250 -3075 10644 26006 180488 CAROL J PALMER 141097 5811 6639 13455 16742 183744 CAROL A BRADLEY 312686 17118 15583 41198 31477 418062 10154 ALLYSON D ANDERSON 272142 15215 12572 36159 27150 363238 18887 Sch J, Part III, Additional Information Part III, Additional Information Sch J, Part 1, Question 3 Regarding Compensation PracticesDirectors for Legacy are not compensated, but receive expense reimbursements related to their duties. Any expense reimbursements to board members require review and approval by the Director of Management Audit. Compensation received by Dr. Newberry during 2011 related to his responsibilities as Past President of the Medical Staff at Legacy Meridian Park Hospital. Dr. Root received compensation relating to her duties as President of the Legacy Emanuel Medical Staff & compensation for medical services provided to Legacy Emanuel HospitalExecutive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates. Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for executive positions. The Committee oversees the system's governance procedures with respect to intermediate sanctions legislation and the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Sch J, Part II, Column Breakdown Of W-2 Or Misc-1099:Column B(i) - Base compensation consists of regular base pay including employee elected deferrals for retirement plans (403(b) and 457(b) plans).Column B(ii) - The incentive compensation program for Legacy is based on predetermined criteria and reviewed and approved by the Board. Bonuses are paid to key employees for interim duties outside their primary responsibilities (e.g. Acting in Capacity).Column B(iii) - Other compensation consists of deferred compensation amounts paid to executives during the current year and were reported on prior form 990 returns. These amounts include arrangements that contain elements of a substantial risk of forfeiture conditioned on continued employment, vesting and/or a noncompete provision upon termination of employment. In addition, imputed income for insurance, cell phone and other benefits is included in other compensation as well as any severance related payments. Column C - Deferred compensation includes the value of defined benefit plans, contributions to defined contribution plans, amounts deferred under the 457(f) plan including earnings, earnings in the 457(b) plan, and the value of the pension restoration plan. Earnings on the 457(f) and 457(b) include gains and losses on the underlying investments. The defined contribution and benefit plans are available to all employees as they become qualified to participate. The pension restoration plan provides executive pension benefits in excess of IRS mandated limits on eligible compensation to key executives. The benefits are unfunded and subject to forfeiture. Executive pension benefits are intended to make the executive's retirement benefit, as a proportion of their final average salary, comparable to all other employees, and are treated as income when paid.Column D - Nontaxable benefits include company paid health and welfare and long term care and disability benefits under group plans.Column F - Current year compensation reported as deferred in prior years. Sch J, Part I, Line 8 Part I, Line 8: Amounts reported on 990 VII pursuant to initial contract exemption described in Regs Legacy enters into initial employment agreements with executives that qualify under the initial contract exception. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee relies on comparable market data and all decisions are documented. Sch J, Part I, Line 6b Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or Legacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets. Form 990, Part X LMPH participates in the Legacy investment pooled funds which include professionally managed equity and fixed income securities in both separately managed portfolios and commingled investment accounts. Investment returns are prorated according to each affiliate's share of the pool. Form 990, Part VI, question 2 Legacy Health System CPC, LLC (CPC) is a common pay agent for Legacy and its affiliates. The CPC files all required federal employment tax returns for Legacy and its affiliates. The number of employees reported on Form W-3 for LMPH is 977. Form 990, Part IV, question 12 Legacy has an audit of its consolidated financial statement which includes consolidating schedules highlighting LMPH's financial results. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Legacy Health's audited and interim consolidated financial statements are publicly available on the Electronic Municipal Market Access(EMMA) (www.emma.msrb.org) and DAC Bond (www.dacbond.com) websites. Legacy's audited consolidated financial statements include consolidating schedules which highlights LMPH's financial results.When changes are made to the LMPH Articles or Bylaws, LMPH discloses and attaches copies to the IRS Form 990, which are publicly available by request or on various public websites such as Guidestar(www.guidestar.org). Other governing documents are not available to the public. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The following describes the compensation practices of Legacy and its affiliates.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee oversees the system's governance procedures with respect to the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The following is a summary of Legacy's policy and procedures for conflict of interest disclosure, monitoring and resolution.All Legacy employees and non-employees in leadership positions (e.g., Board members, Foundation Trustees, Medical Directors) are required to disclose potential conflicts of interest as the conflict arises. All employees attest to proper conflict of interest disclosure during their annual review. Certain groups have annual formal disclosure requirements, Executives and non-employees in leadership positions complete the Conflict Disclosure Statement from the Standards of Conduct policy annually. Officers, Directors, Trustees, Key and Highly Compensated employees are also required to complete a questionnaire covering business relationships, business transactions with interested parties, loans and grants. Conflict Disclosure Statements and questionnaires are returned to Legacy Management Audit for review of the disclosures. If a conflict is disclosed, or identified through any other means, Management Audit ensures that management mitigates the risk (e.g., discontinues relationship with vendor, segregates responsibilities, recuses Board member from voting in area of conflict) and that the conflict and mitigation steps are reported to the appropriate level (e.g., Compliance Committee, Audit Committee of the Board). Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process The Legacy Board received a copy of the 990 return prior to filing. At the direction of the entire Board, the Board Compensation Committee reviewed the compensation disclosures and the Board Audit Committee reviewed the 990 returns for Legacy and Legacy Emanuel Hospital & Health Center with Management prior to filing. Any key differences in disclosure for other affiliated entities, including Legacy Meridian Park Hospital were discussed with the Board Audit Committee. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The appointed persons by the Oregon Synod Council and the Convention of the Episcopal Diocese may not be removed from the Board without written consent of their respective organizations. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors includes the following members: (a) The Bishop of the Oregon Synod of the Evangelical Lutheran Church inAmerica (the "Oregon Synod") or the Bishop's designee, who shall serve ex officio;(b) The Bishop of the Episcopal Diocese of Oregon (the "Episcopal Diocese")or the Bishop's designee, who shall serve ex officio;(c) One (1) person appointed by election of the Oregon Synod Council;(d) One (1) person appointed by election of the Convention of the EpiscopalDiocese. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Legacy Health is the sole member of Legacy Merdian Park Hospital. Form 990, Part VI, Line 3 Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company Legacy Health (Legacy) provides management services for all of its affiliated companies which includes, accounting, purchasing, contracting, legal, human resources, information technology, billing, facilities, budgeting, transcription, security, public relations, strategic planning, organization development. LEGACY ADVENTIST VENTURE 1919 NW LOVEJOY ST PORTLAND OR 97209 931121816 HEALTHCARE OR 501(C)(3) 9 N/A false SALMON CREEK HOSPITAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 830433165 CHARITABLE FOUNDATION WA 501(C)(3) 7 N/A false MT HOOD MEDICAL CENTER FOUNDATION PO BOX 4484 PORTLAND OR 97208 930794951 CHARITABLE FOUNDATION OR 501(C)(3) 11a N/A false MERIDIAN PARK MEDICAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 930773410 CHARITABLE FOUNDATION OR 501(C)(3) 11a N/A true GOOD SAMARITAN FOUNDATION PO BOX 4484 PORTLAND OR 97208 237017276 CHARITABLE FOUNDATION OR 501(C)(3) 11a N/A false THE CHILDRENS HOSPITAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 931314469 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false EMANUEL MEDICAL CENTER FOUNDATION PO BOX 4484 PORTLAND OR 97208 936095667 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false LEGACY VISITING NURSE ASSOCIATION 815 NE DAVIS ST PORTLAND OR 97210 930848530 HOSPICE OR 501(C)(3) 9 N/A false LEGACY SALMON CREEK HOSPITAL 2211 NE 139TH ST VANCOUVER WA 98686 331065485 HOSPITAL WA 501(C)(3) 3 N/A false LEGACY MOUNT HOOD MEDICAL CENTER 24800 SE STARK ST GRESHAM OR 97030 930591528 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY GOOD SAMARITAN HOSPITAL & MEDICAL 1015 NW 22ND AVE PORTLAND OR 97210 930386793 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY EMANUEL HOSPITAL & HEALTH CENTER 2801 N GANTENBEIN AVE PORTLAND OR 97227 930386823 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY HEALTH 1919 NW LOVEJOY ST PORTLAND OR 97209 237426300 HEALTHCARE OR 501(C)(3) 11b N/A false false true true true true true true true true true false true true true true true true true MERIDIAN PARK MEDICAL FOUNDATION h 147946 Cash MERIDIAN PARK MEDICAL FOUNDATION c 232379 Cash