SALEM HEALTH: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SALEM HEALTH (EIN 93-0579722)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201202279349303785
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T18:05:34-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
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 | 680 HAWTHORNE AVE SE 140 | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930579722 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SALE | NameControl |
| Phone | 5035615535 | 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 | AARON R CRANE | Name |
| Title | CHIEF FINANCE & STRATEGY OFFICER | Title |
| Phone | 5035615150 | Phone |
| Date Signed | 2012-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOYLYN M ANKENEY CPA | Name |
| Phone | 5035857774 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | AARON R CRANE | 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 | 584158111 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SALEMHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1970 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | TO IMPROVE THE HEALTH AND WELL BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 4304 | TotalNbrEmployees |
| Total Nbr Volunteers | 325 | TotalNbrVolunteers |
| Total Gross UBI | 2662679 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1312170 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1359173 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 533056532 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 571229821 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4936879 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8871160 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3092356 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1268159 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 542397937 | TotalRevenuePriorYear |
| Total Revenue Current Year | 582728313 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 242960 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 313397 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 260454764 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 279602377 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 257903734 | OtherExpensePriorYear |
| Other Expenses Current Year | 271553207 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 518601458 | TotalExpensesPriorYear |
| Total Expenses Current Year | 551468981 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 23796479 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 31259332 | RevenuesLessExpensesCY |
| Total Assets BOY | 852373971 | TotalAssetsBOY |
| Total Assets EOY | 861384227 | TotalAssetsEOY |
| Total Liabilities BOY | 397485365 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 393996073 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 454888606 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 467388154 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES WE SERVE | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 112459182 | Expense |
| Revenue | 317121582 | Revenue |
| Description | SALEM HOSPITAL IS ONE OF THE LARGEST OF OREGON'S 58 ACUTE CARE HOSPITALS AND OPERATES THE BUSIEST EMERGENCY DEPARTMENT IN OREGON. THERE ARE 442 PHYSICIANS ON THE ACTIVE MEDICAL STAFF, REPRESENTING 46 DIFFERENT SPECIALTIES, WHO ADMIT PATIENTS TO THE HOSPITAL. MORE THAN 447 VOLUNTEERS PROVIDE NON-MEDICAL SUPPORT FOR THE HOSPITAL. 2010 STATISTICS: BIRTHS - 3,199, DIAGNOSTIC IMAGING PROCEDURES - 168,414, ED AND URGENT CARE VISITS - 118,982, INPATIENT ADMISSIONS - 23,275, LABORATORY PROCEDURES - 1,494,514, SURGERIES - 13,545. THE PRIMARY SERVICE AREA IS THE GREATER WILLAMETTE VALLEY WITH APPROXIMATELY 500,000 RESIDENTS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 347108468 | Expense |
| Revenue | 243197076 | Revenue |
| Description | SALEM HOSPITAL PROVIDES HEALTHCARE TO PEOPLE IN OUR COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. IN FY2011, PROVISION OF SERVICES TO INDIVIDUALS WHO CANNOT AFFORD TO PAY ACCOUNTED FOR THE LARGEST PORTION OF THE COMMUNITY BENEFIT, $103.9 MILLION. CHARITY CARE TOTALED $37.8 MILLION; MEDICARE UNDERPAID SALEM HOSPITAL BY $47.8 MILLION. MEDICAID UNDERPAID BY $18.3 MILLION. SALEM HOSPITAL DOES NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST CHARITY CARE PATIENTS WHO HAVE DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 22455701 | Expense |
| Revenue | 9205424 | Revenue |
| Description | SALEM HOSPITAL ACTIVELY PARTICIPATES IN COMMUNITY HEALTH IMPROVEMENT SERVICES. IN FY2011, SALEM HOSPITAL GAVE $9.1 MILLION FOR UNFUNDED OR UNDERFUNDED HEALTH SERVICES, INCLUDING IMPROVING ACCESS TO CARE THROUGH PHYSICIAN RECRUITING, COMMUNITY HEALTH EDUCATION AND PREVENTION PROGRAMS. THE HOSPITAL HAS AN ACTIVE SPEAKERS BUREAU PROVIDING FREE HEALTH LECTURES TO COMMUNITY GROUPS. HEALTH SCREENINGS, SUPPORT GROUPS AND EDUCATION CLASSES ARE OFFERED ON AN ON-GOING BASIS. IN FY2011, SALEM HOSPITAL PROVIDED MORE THAN $786 THOUSAND IN CASH AND IN-KIND DONATIONS TO COMMUNITY HEALTH PROGRAMS SUCH AS MEDASSIST, SALEM FREE CLINIC AND NORTHWEST HUMAN SERVICES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 482023351 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | 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 | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 369 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 4304 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | 1 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| 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 | 5035613500 | 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 (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| KATHERINE KEENE | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| GEORGE HAPP | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| BRUCE CARTER MD | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| KENNETH SHERMAN JR | |||||||||
| CHAIRPERSON | 15.00 | X | 0 | 0 | 0 | X | |||
| DAVID ELMGREN MD | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| CHUCK HUDKINS | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| BONNIE DRIGGERS RN | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| THERESA TAAFFE | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| ALAN WYNN | |||||||||
| SECRETARY/TREASURER | 10.00 | X | 0 | 0 | 0 | X | |||
| ALAN COSTIC | |||||||||
| VICE-CHAIRPERSON | 15.00 | X | 0 | 0 | 0 | X | |||
| LANE SHETTERLY | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| ROBERT WELLS | |||||||||
| TRUSTEE | 10.00 | X | 0 | 0 | 0 | ||||
| NORMAN GRUBER | |||||||||
| PRESIDENT | 40.00 | 823665 | 0 | 53837 | X | ||||
| AARON CRANE | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 428267 | 0 | 76871 | X | ||||
| WILLIAM HOLLOWAY MD | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 497067 | 0 | 79878 | X | ||||
| JACK CAYNON | |||||||||
| GENERAL COUNSEL | 40.00 | 319201 | 0 | 67869 | X | ||||
| BEVERLY BOW | |||||||||
| VP HUMAN RESOURCES | 40.00 | 268879 | 0 | 52835 | X | ||||
| CHERYL NESTER-WOLFE | |||||||||
| CHIEF NURSING OFFICER | 40.00 | 405815 | 0 | 66235 | X | ||||
| KENNETH KUDLA | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 319357 | 0 | 58981 | X | ||||
| ANNE MARIE DIAMOND | |||||||||
| VP SERVICE LINE OPR. | 40.00 | 61230 | 0 | 16259 | X | ||||
| MARTIN MORRIS | |||||||||
| EXEC DIR FOUNDATION | 40.00 | 241504 | 0 | 55208 | X | ||||
| NICOLE VANDERHEYDEN MD | |||||||||
| TRAUMA SURGEON | 40.00 | 489992 | 0 | 72899 | X | ||||
| AHMED EBEID MD | |||||||||
| PHYSICIAN | 40.00 | 516751 | 0 | 71603 | X | ||||
| TRACY TAGGERT MD | |||||||||
| GENERAL SURGEON | 40.00 | 356493 | 0 | 57449 | X | ||||
| NANCY BOUTIN | |||||||||
| PHYSICIAN | 40.00 | 362417 | 0 | 42699 | X | ||||
| AMR HEGAZI | |||||||||
| ANESTHESIOLOGIST | 40.00 | 515898 | 0 | 52126 | X | ||||
| VIRGINIA POSEY | |||||||||
| VP/PATIENT CARE | 40.00 | 196379 | 0 | 17543 | X | ||||
| PATRICIA HARGER | |||||||||
| VP STRATEGIC PLANNING | 40.00 | 241043 | 0 | 38902 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5982728 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 864935 | TotalOtherCompensation |
| Number Individuals GT100 K | 255 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PHOENIX HEALTH SYSTEMS INC | |||||
| 1130 EAST ARAPAHO ROAD SUITE 500 | RICHARDSON | TX | 75081 | IT SUPPORT SERVICES | 4598962 |
| SOUND INPATIENT PHYSICIANS | |||||
| 1123 PACIFIC AVE | TACOMA | WA | 98402 | HOSPITALIST COVERAGE | 1561079 |
| CSC AMERICAS OUTSOURCING | |||||
| 3170 FAIRVIEW PARK DRIVE | FALLS CHURCH | VA | 22042 | IT SUPPORT SERVICES | 1435909 |
| SHIFTWISE | |||||
| 1800 SW 1ST AVE SUITE 510 | PORTLAND | OR | 97201 | CONTRACT LABOR | 1338610 |
| OREGON ANESTHESIOLOGY GROUP | |||||
| 120 NW 14TH AVE SUITE 300 | PORTLAND | OR | 97209 | ANESTHESIA COVERAGE | 1272371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 45 | NumberOfContractorsGT100K |
| Related Organizations | 1281110 | RelatedOrganizations |
| All Other Contributions | 78063 | AllOtherContributions |
| Total Contributions | 1359173 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT PAYMENTS | 621110 | 556069208 | 556069208 | |
| PHARMACY | 446110 | 5833969 | 4958864 | 875105 |
| NUTRITION SERVICES | 722210 | 3960284 | 3960284 | |
| OTHER HOSPITAL SERVICE | 900099 | 3613511 | 3462099 | 151412 |
| REGIONAL LAB | 621500 | 1752849 | 119418 | 1633431 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 571229821 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8098618 | TotalRevenueColumn |
| Exclusion | $8,098,618 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1291713 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 980494 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 311219 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 311219 | TotalRevenueColumn |
| Exclusion | $311,219 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 520202 | Securities |
| Other | 701644 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 449304 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 520202 | Securities |
| Other | 252340 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 772542 | TotalRevenueColumn |
| Exclusion | $772,542 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PASSTHROUGH INCOME | Description |
| Business Code | 541900 | BusinessCode |
| Total Revenue Column | 956940 | TotalRevenueColumn |
| Related Or Exempt Function Income | 954209 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2731 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 956940 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 582728313 | TotalRevenueColumn |
| Related Or Exempt Function Income | 569524082 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2662679 | UnrelatedBusinessRevenue |
| Exclusion | $9,182,379 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 313397 | Total |
| Program Services | 313397 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1530315 | Total |
| Management And General | 1530315 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 216352683 | Total |
| Program Services | 198227784 | ProgramServices |
| Management And General | 18124899 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46023454 | Total |
| Program Services | 42138188 | ProgramServices |
| Management And General | 3885266 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15695925 | Total |
| Program Services | 14295847 | ProgramServices |
| Management And General | 1400078 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1022489 | Total |
| Program Services | 1021989 | ProgramServices |
| Management And General | 500 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 923902 | Total |
| Program Services | 14805 | ProgramServices |
| Management And General | 909097 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350752 | Total |
| Program Services | 25000 | ProgramServices |
| Management And General | 325752 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115418 | Total |
| Management And General | 115418 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23756576 | Total |
| Program Services | 19027568 | ProgramServices |
| Management And General | 4729008 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 536278 | Total |
| Program Services | 1788 | ProgramServices |
| Management And General | 534490 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21948673 | Total |
| Program Services | 4053847 | ProgramServices |
| Management And General | 17894826 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7016072 | Total |
| Program Services | 614408 | ProgramServices |
| Management And General | 6401664 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12316085 | Total |
| Program Services | 10694184 | ProgramServices |
| Management And General | 1621901 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 952312 | Total |
| Program Services | 603852 | ProgramServices |
| Management And General | 348460 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 959641 | Total |
| Program Services | 731304 | ProgramServices |
| Management And General | 228337 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12873767 | Total |
| Program Services | 12873719 | ProgramServices |
| Management And General | 48 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41572280 | Total |
| Program Services | 41572280 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3746861 | Total |
| Program Services | 3746861 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PATIENT SUPPLIES | 90496326 | 89712121 | 784205 |
| LOSS ON EXTINGUISHMENT | 33668797 | 33668797 | |
| OTHER PURCHASED SERVICE | 14748482 | 7848570 | 6899912 |
| RECRUITING | 2184233 | 43706 | 2140527 |
| SPECIAL EVENTS | 684157 | 268505 | 415652 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1680106 | Total |
| Program Services | 524831 | ProgramServices |
| Management And General | 1155275 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551468981 | Total |
| Program Services | 482023351 | ProgramServices |
| Management And General | 69445630 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23885 | BOY |
| EOY | 23955 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10442917 | BOY |
| EOY | 335623 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69787450 | BOY |
| EOY | 71683333 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6574010 | BOY |
| EOY | 3902837 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5688249 | BOY |
| EOY | 5943376 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7003379 | BOY |
| EOY | 6208152 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 790739293 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 339518455 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 454726188 | BOY |
| EOY | 451220838 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 261587017 | BOY |
| EOY | 285573040 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8371401 | BOY |
| EOY | 6074189 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28169475 | BOY |
| EOY | 30418884 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 852373971 | BOY |
| EOY | 861384227 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57284137 | BOY |
| EOY | 51339233 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 307894664 | BOY |
| EOY | 306208933 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3235865 | BOY |
| EOY | 2064133 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29070699 | BOY |
| EOY | 34383774 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 397485365 | BOY |
| EOY | 393996073 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 452984797 | BOY |
| EOY | 465602946 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1903809 | BOY |
| EOY | 1785208 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 454888606 | BOY |
| EOY | 467388154 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 852373971 | BOY |
| EOY | 861384227 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 31259332 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -18759784 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 | 1903809 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -118601 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1785208 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2363674 | BeginningOfYearBalance |
| Contributions | 527436 | Contributions |
| Investment Earnings Or Losses | 246579 | InvestmentEarningsOrLosses |
| Other Expenditures | 1233880 | OtherExpenditures |
| End Of Year Balance | 1903809 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3255208 | BeginningOfYearBalance |
| Contributions | 987591 | Contributions |
| Investment Earnings Or Losses | 57741 | InvestmentEarningsOrLosses |
| Other Expenditures | 1936866 | OtherExpenditures |
| End Of Year Balance | 2363674 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23127024 | OtherCostOrOtherBasis |
| Book Value | 23127024 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 16588634 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 459941721 | OtherCostOrOtherBasis |
| Depreciation | 135410337 | Depreciation |
| Book Value | 341120018 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 272577513 | OtherCostOrOtherBasis |
| Depreciation | 200265653 | Depreciation |
| Book Value | 72311860 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18504401 | OtherCostOrOtherBasis |
| Depreciation | 3842465 | Depreciation |
| Book Value | 14661936 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 451220838 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| FAIR VALUE INTEREST RATE SWAP AGREEMENT | $17,912,224 |
| ACCRUED POST RETIREMENT HEALTHCARE BENEFITS | $7,920,595 |
| ACCRUED MALPRACTICE INSURANCE | $4,597,467 |
| ESTIMATED LIABILITY TO MEDICARE | $3,868,731 |
| DUE TO SALEM HEALTH | $49,141 |
| OTHER LONG-TERM LIABILITIES | $35,616 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 34383774 | TotalOfAmounts |
| Total Revenue | 582728313 | TotalRevenue |
| Total Expenses | 551468981 | TotalExpenses |
| Excess Or Deficit For Year | 31259332 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -11566383 | NetUnrealizedGLOnInvestments |
| Other | -$7,193,401 | OtherAmount |
| Total Adjustments | -18759784 | TotalAdjustments |
| Excess Or Deficit Per FS | 12499548 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 587896035 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 5283140 | OtherRevenues |
| Revenue Not Rptd F990 | 5283140 | RevenueNotRptdF990 |
| Revenue Subtotal | 582612895 | RevenueSubtotal |
| Investment Expenses Not Included | 115418 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 115418 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 582728313 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 575396487 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 24042924 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 24042924 | ExpensesNotRptdF990 |
| Expenses Subtotal | 551353563 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 115418 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 115418 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 551468981 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS ARE HELD BY SALEM HOSPITAL FOUNDATION FOR SALEM HOSPITAL SUPPORT. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -3,490,707. CHANGE IN NET BENEFIT COST -666,155. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION -118,601. GAIN ON DISCONTINUED OPERATIONS 388,729. EQUITY TRANSFERS -3,306,667. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | REIMBURSEMENTS TREATED AS REVENUE ON FINANCIAL STATEMENT 4,894,411. DISCONTINUED OPERATIONS 388,729. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 3,490,707. CHANGE IN POSTRETIREMENT BENEFIT OBLIGATION 666,155. NET UNREALIZED LOSS ON INVESTMENTS 11,566,383. EQUITY TRANSFERS 3,306,667. REIMBURSEMENTS TREATED AS REVENUE ON FINANCIAL STATEMENT 4,894,411. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 118,601. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 57498 | PersonsServed |
| Total Community Benefit Expense | 37609785 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 37609785 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07260 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 69279 | PersonsServed |
| Total Community Benefit Expense | 81279716 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 63682316 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17597400 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03400 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 126777 | PersonsServed |
| Total Community Benefit Expense | 118889501 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 63682316 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 55207185 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10660 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 577404 | PersonsServed |
| Total Community Benefit Expense | 2880195 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 68919 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2811276 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00540 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1129577 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1129577 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15451687 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9127713 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6323974 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01220 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2199800 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2199800 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00420 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 794442 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8792 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 785650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 577404 | PersonsServed |
| Total Community Benefit Expense | 22455701 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9205424 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13250277 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02550 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 704181 | PersonsServed |
| Total Community Benefit Expense | 141345202 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 72887740 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 68457462 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13210 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 417478 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 417478 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 417478 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 417478 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $15,012,638 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 77012846 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 94969246 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -17956400 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 OREGON COMMUNITY IMAGING LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | MEDICAL IMAGING COOPERATIVE | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.50000 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.50000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HOSPITAL | BusinessNameLine1 |
Address Address
| 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) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 6 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| REHAB | ||||
| 2561 CENTER ST | SALEM | OR | 97301 | REHABILITATION |
| WILLAMETTE VALLEY MIDWIVES | ||||
| 1285 LIBERTY ST | SALEM | OR | 97301 | MIDWIFERY |
| COMPREHENSIVE PAIN CENTER | ||||
| 280 LIBERTY ST | SALEM | OR | 97301 | PAIN MANAGEMENT |
| REGIONAL LABORATORY | ||||
| 3300 STATE ST | SALEM | OR | 97301 | LABORATORY SERVICES |
| WHP FAMILY MEDICINE KEIZER | ||||
| 550 DEITZ AVE NE | KEIZER | OR | 97303 | CLINIC |
| WHP FAMILY MEDICINE RIVER ROAD S | ||||
| 2925 RIVER RD S | SALEM | OR | 97302 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: IT IS THE POLICY OF SALEM HOSPITAL TO PROVIDE FINANCIAL COUNSELING TO PATIENTS REGARDING THEIR FINANCIAL OBLIGATION AT THE EARLIEST OPPORTUNITY POSSIBLE. SALEM HOSPITAL PROVIDES A VARIETY OF OPTIONS TO ASSIST PATIENTS IN RESOLVING THEIR ACCOUNTS, INCLUDING: OREGON HEALTH PLAN (OHP) SCREENING, CHARITY ASSISTANCE, MEDICAL FINANCING CARDS, LOANS, AND EXTENDED PAYMENT PLANS. DISCOUNTS MAY BE AVAILABLE ON THE NET BALANCE FOR PATIENTS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. PATIENTS AT OR BELOW 200% OF THE POVERTY LEVEL ARE ELIGIBLE FOR 100% CHARITY ASSISTANCE.THE HOSPITAL CONSIDERS BOTH INCOME AND/OR ASSETS AVAILABLE TO PAY PATIENT'S MEDICAL EXPENSES1.THE HOSPITAL WILL MULTIPLY THE FAMILY INCOME BY 30%2.THE HOSPITAL WILL DETERMINE THE PATIENT'S ALLOWABLE MEDICAL EXPENSES3.THE HOSPITAL WILL COMPARE 30% OF THE FAMILY INCOME TO THE TOTAL OF THE PATIENT'S ALLOWABLE MEDICAL EXPENSES. IF THE TOTAL OF THE ALLOWABLE MEDICAL EXPENSES IS GREATER THAN 30% OF THE FAMILY INCOME, THEN THE PATIENT MEETS THE CATASTROPHIC CHARITY CARE QUALIFICATION. THE HOSPITAL WILL LIMIT PATIENT LIABILITY FOR MEDICAL EXPENSES TO 30% OF THE FAMILY'S INCOME. AMOUNTS THAT EXCEED THIS LIMIT WILL BE ELIGIBLE FOR CHARITY CARE.FOR EXAMPLE: FAMILY INCOME OF $70,000 PER YEAR AND MEDICAL EXPENSES OF $45,000. THIRTY-PERCENT OF THE FAMILY'S ANNUAL INCOME IS $21,000; THE FAMILY'S MEDICAL EXPENSES OF $45,000 EXCEED THIS AMOUNT. THE FAMILY SHOULD THEREFORE BE ELIGIBLE FOR A CHARITY WRITE-OFF OF $24,000.ORASSET TESTASSETS CONSIDERED AVAILABLE TO PAY PATIENT'S MEDICAL EXPENSES1. EQUITY IN A REAL ESTATE, OTHER THAN THE PATIENT'S PERSONAL RESIDENCE, SECURITIES OR OTHER ASSETS (E.G.. RENTAL PROPERTY, AGRICULTURAL USE) IS CONSIDERED AVAILABLE TO PAY THE PATIENT'S MEDICAL EXPENSES.2. $201,000 REPRESENTS THE MEDIAN VALUE OF A HOME IN SALEM, OREGON AS OF AUGUST 2010. THE HOSPITAL CONSIDERS THIS AMOUNT TO BE PROTECTED FROM CONSIDERATION AS A FUNDING SOURCE. EQUITY IN A PATIENT'S PERSONAL RESIDENCE OVER AND ABOVE $201,000 WILL BE CONSIDERED AS AVAILABLE TO PAY MEDICAL LIABILITIES.3. THE CATASTROPHIC LIMIT UNDER THIS TEST WILL BE ESTABLISHED AT 100% OF THE EQUITY IN REAL PROPERTY OVER AND ABOVE THE FIRST $201,000 IN A PRIMARY RESIDENCE, AND 100% OF THE EQUITY IN OTHER REAL PROPERTY PRODUCING INCOME.FOR EXAMPLE: $280,000 (MARKET VALUE) - $100,000 (MORTGAGE) = $180,000 (NET VALUE); THEREFORE, $201,000 (PROTECTED SO EQUITY WOULD NOT BE CONSIDERED) | ||
| PART I, LINE 7: NET COMMUNITY BENEFIT EXPENSE IS CALCULATED BY TOTAL COSTS OF CARE PROVIDED LESS THE DIRECT, OFFSETTING NET REVENUES FOR THOSE SERVICES. THE COSTS TO PROVIDE CHARITY CARE AND MEDICAID SERVICES DISCLOSED IN LINE 7, COLUMN (C) LINES (A) AND (B), RESPECTIVELY, ARE DETERMINED BY APPLYING THE COST TO CHARGE RATIO AS DETERMINED IN WORKSHEET 2 TO THE FULL BILLED CHARGES FOR THE SERVICES RENDERED. NET COMMUNITY BENEFIT EXPENSE FOR THE COSTS FOR SUBSIDIZED HEALTH SERVICES DISCLOSED IN PART I, LINE 7(G) USES AN INTERNAL COSTING SYSTEM WHEREBY DIRECT AND INDIRECT EXPENSES ARE ALLOCATED TO DISCRETE OFFSETTING NET REVENUES FOR EACH SERVICE. OVERHEAD COSTS ARE ALLOCATED TO REVENUE GENERATING SERVICES BASED ON UTILIZATION STATISTICS SUCH AS SQUARE FOOTAGE FOR MAINTENANCE COSTS. | ||
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSE THAT WAS INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A), BUT REMOVED FROM THIS FIGURE FOR THE PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS $33,668,797. | ||
| PART II: IN 2011, SALEM HOSPITAL PROVIDED EXECUTIVE LEADERSHIP TO THE BOARD OF WALTON HOUSE, A RESPITE HOUSING PROVIDER. THE HEALTH EDUCATION DIVISION HOSTED AN ANNUAL UPDATE OF COMMUNITY BENEFIT ACTIVITIES FOR COMMUNITY PARTNERING AGENCIES. MARION AND POLK COUNTY MUA/HPSA DESIGNATION, HEALTH ASSESSMENT DATA SETS AND MARION POLK RESIDENT (2008) SURVEY RESULTS DEMONSTRATE HEALTHCARE ACCESS PROBLEMS, SPECIFICALLY LACK OF PHYSICIANS WILLING TO TAKE MEDICARE AND OREGON HEALTH INSURANCE (MEDICAID). LIKEWISE, ACCESS TO HEALTHCARE WAS ALSO ONE OF THE TOP THREE COMMUNITY HEALTH CONCERNS CITED BY PROVIDERS SURVEY RESPONDENTS. WHILE REGION 3, WHICH INCLUDES MARION, BENTON, LANE, LINN AND POLK COUNTIES, HAS 94 (OR 111) PRIMARY CARE PROVIDERS PER 100,000 POPULATION, ONLY 86 (OR 98) OF THOSE ACCEPT MEDICARE, AND OF THOSE 86, ONLY A PORTION ARE ACTUALLY ACCEPTING NEW PATIENTS. A SIMILAR SITUATION EXISTS FOR OREGON HEALTH PLAN; EVEN WHEN PEOPLE HAVE COVERAGE, THEY MAY NOT HAVE ACCESS TO ESTABLISHING CARE WITH A LOCAL MEDICAL PROVIDER. TO EASE THE BURDEN OF ACCESS TO CARE AND TO ENSURE A WELL TRAINED HEALTH PROFESSIONAL WORKFORCE, SALEM HOSPITAL CONTINUES TO MAKE A SIGNIFICANT INVESTMENT IN PHYSICIAN RECRUITMENT AND MEDICAL WORK FORCE DEVELOPMENT. | ||
| PART III, LINE 4: BAD DEBT EXPENSE IS RECORDED ON THE BASIS FOR FULL BILLED CHARGES THAT THE HOSPITAL WAS UNABLE TO COLLECT AFTER SUCH PAYOR ALLOWANCES, CHARITY REDUCTIONS AND SELF-PAY DISCOUNTS. COST OF BAD DEBT EXPENSE DISCLOSED IN LINES 2 AND 3 ARE CALCULATED BY APPLYING THE RATIO OF COSTS TO CHARGES AS DETERMINED IN WORKSHEET 2 TO THE FULL BILLED CHARGES WRITTEN OFF AS BAD DEBT EXPENSE AS REPORTED IN THE AUDITED FINANCIAL STATEMENTS. | ||
| PART III, LINE 8: MEDICARE PAYORS PAY A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR ENROLLEES SUCH THAT THE NET REIMBURSEMENT DOES NOT EVEN COVER THE EXPENSES INCURRED TO PROVIDE THE SERVICE. SALEM HOSPITAL CONSIDERS THE DIFFERENCE BETWEEN THE COSTS TO PROVIDE CARE FOR MEDICARE ENROLLEES AND THE NET REIMBURSEMENT AS A BENEFIT TO THE COMMUNITY. MEDICARE FEE-FOR-SERVICE COSTS ARE DETERMINED FROM SALEM HOSPITALS FILED MEDICARE COST REPORT. THE CALCULATION OF NET BENEFIT IS EQUAL TO TOTAL MEDICARE PAYMENTS LESS MEDICARE COSTS. IN ADDITION TO TRADITIONAL MEDICARE FEE-FOR-SERVICE, SALEM HOSPITAL PROVIDES SUBSTANTIAL SERVICES TO OTHER MEDICARE POPULATIONS PARTICIPATING IN MEDICARE ADVANTAGE PLANS AT SIGNIFICANTLY REDUCED REIMBURSEMENT. THE NET REVENUES FOR THESE PLANS ARE LESS THAN THE COST TO PROVIDE CARE AND ARE NOT DISCLOSED IN PART III, LINE 8. SALEM HOSPITAL ALSO CONSIDERS THE DIFFERENCE BETWEEN THE NET COST TO PROVIDE CARE FOR MEDICARE ADVANTAGE ENROLLEES AND THE NET REIMBURSEMENT AS A BENEFIT TO THE COMMUNITY. THESE NET COSTS HAVE BEEN DETERMINED BY APPLYING THE RATIO OF COSTS TO CHARGES AS DETERMINED IN WORKSHEET 2 TO THE FULL BILLED CHARGES. THE CALCULATION OF NET BENEFIT IS EQUAL TO TOTAL MEDICARE ADVANTAGE PAYMENTS OF $102,501,914 LESS MEDICARE ADVANTAGE COSTS OF $131,017,322 FOR A TOTAL ADDITIONAL COMMUNITY BENEFIT IN THE AMOUNT OF $28,515,408. | ||
| PART III, LINE 9B: IF THERE IS AN INDICATION THAT A PATIENT MAY BE UNABLE TO PAY THEIR BILL, A FINANCIAL QUESTIONNAIRE IS GIVEN OR SENT TO THE PATIENT. UPON RECEIPT OF THE COMPLETED QUESTIONNAIRE, THE PATIENT FINANCIAL COUNSELOR WILL DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFY THE PATIENT REGARDING THEIR ELIGIBILITY FOR DISCOUNTS UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ELIGIBILITY IS DETERMINED BASED ON THE QUESTIONNAIRE AND SUPPORTING DOCUMENTATION IN ACCORDANCE TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. | ||
| PART V, SECTION B, LINE 19D: IT IS THE POLICY OF SALEM HOSPITAL TO PROVIDE EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL WILL USE THE NORMAL BILLING RATES FOR SERVICES PROVIDED AT THE HOSPITAL FACILITY. | SALEM HOSPITAL | |
| PART V, SECTION B, LINE 21: IT IS THE POLICY OF SALEM HOSPITAL TO BILL ALL PATIENTS THE NORMAL BILLING RATE REGARDLESS OF THEIR ABILITY TO PAY. | SALEM HOSPITAL | |
| PART VI, LINE 2: A COMPREHENSIVE COMMUNITY NEEDS AND ASSET ANALYSIS IS COMPLETED EVERY THREE TO FIVE YEARS USING PRIMARY AND SECONDARY DATA SETS. THE 2008-2009 MARION AND POLK COUNTY HEALTH ASSESSMENTS, SALEM HOSPITAL SERVICE LINE PLANNING DOCUMENTS, DISEASE SPECIFIC AND EMERGENCY DEPARTMENT DATA SETS, AS WELL AS QUALITATIVE INFORMATION GATHERED FROM COMMUNITY FOCUS GROUPS WERE AMONG DATA REVIEWED IN PLANNING 2009-2011 COMMUNITY BENEFIT ACTIVITIES. SALEM HOSPITAL USES THESE DATA SETS TO DETERMINE POPULATION HEALTH NEEDS; ANALYZE HEALTHCARE DELIVERY SYSTEMS IN RELATION TO SERVICE DEMAND, AND INTEGRATES THESE ANALYSES, TO IDENTIFY GAPS AND SET PLANNING PRIORITIES. THE HOSPITAL IS CURRENTLY WORKING WITH THE COUNTIES TO UNDERTAKE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS NEW ASSESSMENT WILL TAKE INTO CONSIDERATION THE NEW CHNA AND RELATED RULES IMPLEMENTED UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. THE COMMUNITY BENEFIT PROGRAM SUPPORTS THE SALEM HOSPITAL MISSION, VISION, VALUES AND CORE COMMITMENTS THROUGH: - ENHANCING CLINICAL OUTCOMES FOR OUR UNDERSERVED POPULATIONS AND CREATING ACCESS TO CARE THAT PREVIOUSLY WAS NOT EASILY ATTAINABLE - INVESTING DOLLARS BACK INTO THE COMMUNITY AS A DEMONSTRATION OF OUR COMMITMENT TO THE COMMUNITY WE SERVE. - SUPPORTING COMMUNITY OUTREACH AND COMMUNITY EDUCATION RELATED TO SPECIFIC CLINICAL SERVICE LINES AND INTEGRATING ACTIVITIES PRIMARILY RELATED TO EARLY PREVENTION, DETECTION AND SCREENING AND MANAGEMENT OF CHRONIC DISEASE.- SUPPORTING COMMUNITY-BUILDING ACTIVITIES AND WORKFORCE DEVELOPMENT THAT ADDRESSES THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ACCESS TO CARE. THESE ACTIVITIES SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION.THE PLAN ALIGNS WITH A LONG TERM STRATEGY, TO ENSURE THAT SALEM HOSPITAL'S REACH, REPUTATION, AND CORPORATE CITIZENSHIP ARE LEVERAGED TO OPTIMIZE COMMUNITY BENEFIT. THE PLAN CONSISTS OF COMMUNITY-BASED ACTIVITIES WHOSE KEY FUNCTION IS SERVICE TO THOSE IN NEED, INCREASING ACCESS TO CARE AND HEALTH PROMOTION, PREVENTION, AND MANAGEMENT OF CHRONIC DISEASE.THE SALEM HOSPITAL 2009-2011 COMMUNITY BENEFIT PLAN IDENTIFIES THE FOLLOWING COMMUNITY BENEFIT PRIORITIES BASED ON THE 2008/2009 COMMUNITY NEEDS ASSESSMENT. - ADDRESS SOCIOECONOMIC INEQUALITIES IN HEALTH CARE DELIVERY - IMPROVE ACCESS TO CARE THROUGH PHYSICIAN RECRUITMENT AND FINANCIAL AND IN-KIND SUPPORT FOR PRIMARY AND PRENATAL CARE SERVICES.- PROMOTE HEALTH IMPROVEMENT AND PREVENTION OF INJURY AND CHRONIC DISEASE- PROVIDE EARLY DETECTION AND SCREENING AND ENABLE SELF-MANAGEMENT OF CHRONIC DISEASE - SUPPORT COMMUNITY AND PROFESSIONAL HEALTH EDUCATION AND CLINICAL AND COMMUNITY HEALTH RESEARCH- BUILD RELATIONSHIPS WITHIN OUR GREATER SERVICE AREA TO ENSURE THAT SALEM HOSPITAL IS IDENTIFIED AS THE COMMUNITY RESOURCE FOR HEALTH SERVICES BY ALL. HOSPITAL SENIOR LEADERSHIP, IN CONJUNCTION WITH THE BOARD OF TRUSTEES, REVIEWS AND APPROVES THE COMMUNITY BENEFIT PLAN AND BUDGET. | ||
| PART VI, LINE 3: IT IS THE POLICY OF SALEM HOSPITAL TO PROVIDE FINANCIAL COUNSELING TO PATIENTS REGARDING THEIR FINANCIAL OBLIGATION AT THE EARLIEST OPPORTUNITY POSSIBLE. SALEM HOSPITAL PROVIDES A VARIETY OF OPTIONS TO ASSIST PATIENTS IN RESOLVING THEIR ACCOUNTS, INCLUDING: OREGON HEALTH PLAN (OHP) SCREENING, CHARITY ASSISTANCE, LOANS, AND EXTENDED PAYMENT PLANS. DISCOUNTS MAY BE AVAILABLE ON THE NET BALANCE FOR PATIENTS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. PATIENTS AT OR BELOW 200% OF THE POVERTY LEVEL ARE ELIGIBLE FOR 100% CHARITY ASSISTANCE.ALL UNINSURED PATIENTS WITH BALANCES OVER $500 ARE SCREENED FOR ELIGIBILITY THROUGH THE OREGON HEALTH PLAN (OHP), CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) ELIGIBILITY, AND/OR ELIGIBILITY INTO THE FAMILY HEALTH INSURANCE ASSISTANCE PLAN (FHIAP) PROGRAM.SALEM HOSPITAL OR ITS REPRESENTATIVE WILL REVIEW THE PATIENT'S CURRENT RESOURCES AND WORK WITH HIM/HER TO GAIN ELIGIBILITY FOR ANY OF THESE PROGRAMS AS APPROPRIATE.PATIENTS THAT ARE NOT ELIGIBLE FOR OHP OR THE OTHER PROGRAMS LISTED ABOVE, AND HAVE FINANCIAL CONSTRAINTS THAT INHIBIT THEIR ABILITY TO PAY, WILL BE ASSESSED FOR EITHER CHARITY CARE OR A FINANCIAL DISCOUNT.INFORMATION ON THE HOSPITAL'S CHARITY CARE & FINANCIAL POLICY SHALL BE MADE PUBLICLY AVAILABLE IN THE FOLLOWING MANNER:- NOTICES ARE POSTED IN KEY AREAS OF THE HOSPITAL, INCLUDING ADMITTING, THE EMERGENCY DEPARTMENT, OUTPATIENT DEPARTMENT REGISTRATION AREAS, AND THE BUSINESS OFFICE. - THE CONDITIONS OF ADMISSION FORM INFORMS THE PATIENT OF THEIR RIGHT TO APPLY FOR CHARITY CARE. - WRITTEN INFORMATION SHALL BE AVAILABLE IN ENGLISH AND SPANISH. THE HOSPITAL WILL PROVIDE THE APPROPRIATE INTERPRETATION SERVICES FOR ALL PATIENTS WHO DO NOT SPEAK ENGLISH. - FRONT-LINE STAFF IS TRAINED TO ANSWER CHARITY CARE QUESTIONS EFFECTIVELY AND WILL DIRECT ANY QUESTIONS THAT CANNOT BE ANSWERED TO BUSINESS OFFICE STAFF IN A TIMELY MANNER. - THIS POLICY IS POSTED ON SALEM HOSPITAL'S WEB SITE. WRITTEN INFORMATION ABOUT THIS POLICY IS MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION. - THE FIRST PATIENT STATEMENT WILL INCLUDE A NOTICE THAT CHARITY CARE AND/OR FINANCIAL ASSISTANCE IS AVAILABLE. | ||
| PART VI, LINE 4: SALEM HOSPITAL SERVES THE COMMUNITIES WITHIN MARION AND POLK COUNTIES IN THE UPPER WILLAMETTE VALLEY IN THE STATE OF OREGON. THE CITIES INCLUDE SALEM (THE CAPITAL OF OREGON), KEIZER, SILVERTON, STAYTON, DALLAS, WOODBURN, MILL CITY, AUMSVILLE, INDEPENDENCE, GRANDE RONDE, MONMOUTH, SUBLIMITY, MT. ANGEL AND JEFFERSON. THE FOLLOWING ARE SOME OF THE KEY DEMOGRAPHICS IN 2008-2009 MARION AND POLK COUNTIES:GENERAL DEMOGRAPHICS:- POPULATION: 362,990 - POLK COUNTY IS THE 3RD FASTEST GROWING COUNTY IN OREGON. - 63% OF THIS GROWTH IS RELATED TO BIRTHS EXCEEDING DEATHS - 37% OF THE GROWTH IS RELATED TO MIGRATION TO MARION/POLK COUNTIES. - TOTAL BIRTHS PER YEAR: APPROXIMATELY 9,000 - MEDIAN HOUSEHOLD INCOME IS $40,314, SLIGHTLY LOWER THAN THE STATE AVERAGE OF $40,916. - HOME OWNERSHIP RATE IS 62.9% COMPARED TO THE STATE AVERAGE OF 64.3% - LAND AREA FOR MARION AND POLK COUNTIES COMBINED IS 1,925 SQUARE MILES. HEALTHCARE DEMOGRAPHICS:- 15% OF THE POPULATION HAS HEALTHCARE COVERAGE PROVIDED BY MEDICARE - 13% OF THE POPULATION HAVE HEALTHCARE COVERAGE PROVIDED BY MEDICAID - 15% OF THE POPULATION HAS NO HEALTHCARE COVERAGE AT ALL! HEALTHCARE ACCESS (MEDICAL, DENTAL AND BEHAVIOR HEALTH) IS A SIGNIFICANT CHALLENGE IN MARION AND POLK COUNTY. COST OF CARE, LACK OF INSURANCE AND LIMITED PROVIDERS ACCEPTING MEDICAID AND MEDICARE WERE IDENTIFIED IN THE NEEDS ASSESSMENT. DATA ANALYSIS IDENTIFIED CHILDHOOD OBESITY, HIGH TEEN PREGNANCY RATES, EARLY TEEN TOBACCO AND ALCOHOL USE, AND THE NEED TO PROVIDE SERVICES THAT SUPPORT FATHERS TO DEVELOP AND STRENGTHEN PARENTING SKILLS, AS OPPORTUNITIES FOR COMMUNITY-BASED INITIATIVES AND ON-GOING PARTNERSHIPS. | ||
| PART VI, LINE 6: SALEM HOSPITAL IS GOVERNED BY AN ALL-VOLUNTEER COMMUNITY-BASED BOARD OF TRUSTEES (BOARD). HOSPITAL LEADERSHIP AND EXECUTIVE STAFF SERVE ON COMMUNITY NON-PROFIT ADVISORY BOARDS AND PROFESSIONAL ASSOCIATIONS. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN ITS COMMUNITY AND PROVIDES FREE OFFICE SPACE AND OTHER IN-KIND SUPPORT SERVICES TO NON-PROFIT ORGANIZATIONS. SALEM HOSPITAL PROVIDES FINANCIAL SUPPORT AND SPONSORSHIP TO NONPROFIT ORGANIZATIONS. BY LEVERAGING HOSPITAL RESOURCES AND WORKING IN COLLABORATIVE PARTNERSHIPS, SALEM HOSPITAL IS ABLE TO PROVIDE BENEFITS THAT REACH BEYOND HEALTHCARE DELIVERY AND POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH. | ||
| PART VI, LINE 7: SALEM HOSPITAL IS AN OREGON NONPROFIT CORPORATION AND A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. SALEM HEALTH IS THE "PARENT" CORPORATION AND SOLE CORPORATE MEMBER OF THE CORPORATION, SALEM HOSPITAL FOUNDATION, WEST VALLEY HOSPITAL, WEST VALLEY HOSPITAL FOUNDATION, WILLAMETTE VALLEY INSURANCE CORPORATION, AND WILLAMETTE VALLEY PROFESSIONAL SERVICES. ALL ENTITIES WITHIN THE PARENT CORPORATION ARE SEPARATE NONPROFIT CORPORATIONS.SALEM HOSPITAL IS AN OREGON NONPROFIT CORPORATION AND A TAX-EXEMPT ORGANIZATION. THE CORPORATION ALSO DOES BUSINESS UNDER THE NAME "SALEM HOSPITAL, A PART OF SALEM HEALTH." SALEM HOSPITAL IS ONE OF THE LARGEST ACUTE CARE HOSPITALS IN OREGON. LICENSED FOR 454 BEDS, SALEM HOSPITAL OFFERS A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES AN AREA OF OVER 500,000 PEOPLE, INCLUDING ALL OF MARION AND POLK AND PORTIONS OF LINN AND YAMHILL COUNTIES INCLUDING THE RESIDENTS OF THE CITY OF SALEM, THE STATE CAPITAL OF OREGON.SALEM HOSPITAL IS THE LARGEST PRIVATE EMPLOYER IN SALEM, OREGON, WITH APPROXIMATELY 3,300 FULL AND PART-TIME EMPLOYEES (AS OF JUNE 30, 2008). THE MEDICAL STAFF IS COMPRISED OF APPROXIMATELY 500 PHYSICIANS REPRESENTING MORE THAN 50 SPECIALTIES AND SUBSPECIALTIES, AND MORE THAN 400 VOLUNTEERS PROVIDE NON-MEDICAL SUPPORT FOR SALEM HOSPITAL.SALEM HOSPITAL, AS PART OF SALEM HEALTH IS GOVERNED BY AN ALL-VOLUNTEER COMMUNITY-BASED BOARD OF TRUSTEES (BOARD). THE BOARD HAS THE RESPONSIBILITY FOR THE DEVELOPMENT AND OVERSIGHT OF SALEM HEALTH VALUES, VISION, PURPOSE AND LONG-TERM STRATEGY. THROUGH THESE DOCUMENTS, THE COMMUNITY BENEFIT STEERING COMMITTEE ASSESSES AND REAFFIRMS SALEM HOSPITAL'S COMMUNITY BENEFIT COMMITMENTS AND CONNECTIONS WITH COMMUNITY NEEDS AND PRIMARY CONSTITUENCIES. THE COMMUNITY BENEFIT PLAN ASSURES MEASUREMENT AND COMPARISON OF SALEM HOSPITAL'S COMMUNITY ACTIVITIES TO EVOLVING NORMS AND OVERSEES THE CLEAR AND ACCURATE COMMUNICATION OF THESE ACTIVITIES TO KEY CONSTITUENCIES. | ||
| OR | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL FOUNDATION OF MARION & POLK COUNTIES | ||||||||||
| 2995 RYAN DRIVE STE 100 | SALEM | OR | 97301 | 930504197 | 501(C)(3) | 12500 | N/A | N/A | IMPROVE ACCESS TO HEALTHCARE | |
| SALEM FREE MEDICAL CLINIC | ||||||||||
| 3850 PORTLAND ROAD NE | SALEM | OR | 97301 | 203549992 | 501(C)(3) | 44000 | N/A | N/A | ACCESS TO CARE | |
| MARION COUNTY TREASURER | ||||||||||
| 3180 CENTER STREET NE | SALEM | OR | 97301 | 936002307 | MARION COUNTY | 78654 | N/A | N/A | ACCESS TO PRENATAL CARE | |
| AMERICAN CANCER SOCIETY | ||||||||||
| 2120 1ST AV N | SEATTLE | WA | 98121 | 841316555 | 501(C)(3) | 7500 | N/A | N/A | RELAY FOR LIFE SPONSORSHIP | |
| KEIZER CHAMBER OF COMMERCE | ||||||||||
| 980 CHEMAWA RD NE | KEIZER | OR | 97303 | 936030759 | 501(C)(6) | 5000 | N/A | N/A | KEIZER IRIS FESTIVAL RUN SPONSORSHIP | |
| SALEM KEIZER EDUCATION FOUNDATION | ||||||||||
| 233 COMMERCIAL ST NE | SALEM | OR | 97301 | 930831467 | 501(C)(3) | 5000 | N/A | N/A | AWESOME 3000 SPONSORSHIPS | |
| CHEMEKETA COMMUNITY COLLEGE CAMP PROGRAM | ||||||||||
| 4000 LANCASTER DR NE | SALEM | OR | 973097070 | 930585134 | 170(C)(1) | 5000 | N/A | N/A | SCHOLARSHIP FUNDRAISER SPONSORSHIP | |
| WILLAMETTE FAMILY MEDICAL CENTER | ||||||||||
| 755 MEDICAL CENTER DR | SALEM | OR | 97301 | 931180397 | 501(C)(3) | FAIR MARKET VALUE | FREE RENT | ACCESS TO MEDICAL SERVICES | 278866 | |
| PSYCHIATRIC CRISIS CENTER | ||||||||||
| PO BOX 14500 | SALEM | OR | 97309 | 936002307 | MARION COUNTY | FAIR MARKET VALUE | FREE RENT | ACCESS TO MEDICAL SERVICES | 97524 | |
| MEDASSIST AND PROJECT ACCESS | ||||||||||
| 2995 RYAN DRIVE STE 100 | SALEM | OR | 97301 | 931261633 | 501(C)(3) | FAIR MARKET VALUE | FREE RENT | ACCESS TO MEDICAL SERVICES | 20880 | |
| OHSU FOUNDATION DEPT SURGERY | ||||||||||
| 1121 SW SALMON ST | PORTLAND | OR | 97205 | 237083114 | 501(C)(3) | 10000 | N/A | N/A | CHARITABLE CONTRIBUTION GOLF TOURNAMENT SPONSORSHIP | |
| TRINITY LUTHERAN CHURCH | ||||||||||
| 450 SE WASHINGTON | DALLAS | OR | 97338 | 930712329 | 501(C)(3) | 5000 | N/A | N/A | DALLAS FREE CLINIC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 12 | TotalNbrOf501C3AndGovtGrants |
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: GRANTS ARE ONLY MADE TO QUALIFIED EXEMPT ORGANIZATIONS. NO MONITORING IS REQUIRED. | 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 | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORMAN GRUBER | |||||||||||||
| 719931 | 0 | 89166 | 0 | 14568 | 0 | 15925 | 0 | 37912 | 0 | 877502 | 0 | 57667 | 0 |
| AARON CRANE | |||||||||||||
| 397412 | 0 | 19999 | 0 | 10856 | 0 | 44135 | 0 | 32736 | 0 | 505138 | 0 | 0 | 0 |
| WILLIAM HOLLOWAY MD | |||||||||||||
| 470954 | 0 | 23475 | 0 | 2638 | 0 | 46661 | 0 | 33217 | 0 | 576945 | 0 | 0 | 0 |
| JACK CAYNON | |||||||||||||
| 301590 | 0 | 15011 | 0 | 2600 | 0 | 37155 | 0 | 30714 | 0 | 387070 | 0 | 0 | 0 |
| BEVERLY BOW | |||||||||||||
| 250185 | 0 | 13250 | 0 | 5444 | 0 | 33750 | 0 | 19085 | 0 | 321714 | 0 | 0 | 0 |
| CHERYL NESTER-WOLFE | |||||||||||||
| 382213 | 0 | 19999 | 0 | 3603 | 0 | 40356 | 0 | 25879 | 0 | 472050 | 0 | 0 | 0 |
| KENNETH KUDLA | |||||||||||||
| 290501 | 0 | 14578 | 0 | 14278 | 0 | 34083 | 0 | 24898 | 0 | 378338 | 0 | 0 | 0 |
| MARTIN MORRIS | |||||||||||||
| 226518 | 0 | 10929 | 0 | 4057 | 0 | 30338 | 0 | 24870 | 0 | 296712 | 0 | 0 | 0 |
| NICOLE VANDERHEYDEN MD | |||||||||||||
| 458036 | 0 | 0 | 0 | 31956 | 0 | 41173 | 0 | 31726 | 0 | 562891 | 0 | 0 | 0 |
| AHMED EBEID MD | |||||||||||||
| 480218 | 0 | 35000 | 0 | 1533 | 0 | 37571 | 0 | 34032 | 0 | 588354 | 0 | 0 | 0 |
| TRACY TAGGERT MD | |||||||||||||
| 348679 | 0 | 6750 | 0 | 1064 | 0 | 33193 | 0 | 24256 | 0 | 413942 | 0 | 0 | 0 |
| NANCY BOUTIN | |||||||||||||
| 359871 | 0 | 0 | 0 | 2546 | 0 | 17191 | 0 | 25508 | 0 | 405116 | 0 | 0 | 0 |
| AMR HEGAZI | |||||||||||||
| 459733 | 0 | 55500 | 0 | 665 | 0 | 19550 | 0 | 32576 | 0 | 568024 | 0 | 0 | 0 |
| VIRGINIA POSEY | |||||||||||||
| 162743 | 0 | 14449 | 0 | 19187 | 0 | 0 | 0 | 17543 | 0 | 213922 | 0 | 0 | 0 |
| PATRICIA HARGER | |||||||||||||
| 206450 | 0 | 20333 | 0 | 14260 | 0 | 11048 | 0 | 27854 | 0 | 279945 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 4B | SOME OF THE HOSPITAL'S EMPLOYEES RECEIVE DEFERRED COMPENSATION UNDER A 457(F) NONQUALIFIED PLAN. THIS COMPENSATION IS INCLUDED IN COMPENSATION REPORTED IN PART II. THE TOTAL NONQUALIFIED PORTION OF EACH PERSONS DEFERRED COMPENSATION IS: NORMAN GRUBER 34,199 (INCLUDED IN CURRENT YEAR TAXABLE INCENTIVE COMPENSATION) AARON CRANE 28,210 (INCLUDED IN DEFERRED COMPENSATION) WILLIAM HOLLOWAY 33,186 (INCLUDED IN DEFERRED COMPENSATION) CHERYL NESTER WOLFE 26,881 (INCLUDED IN DEFERRED COMPENSATION) KENNETH KUDLA 20,608 (INCLUDED IN DEFERRED COMPENSATION) JACK CAYNON 21,230 (INCLUDED IN DEFERRED COMPENSATION) BEVERLY BOW 17,887 (INCLUDED IN DEFERRED COMPENSATION) MARTIN MORRIS 14,850 (INCLUDED IN DEFERRED COMPENSATION) PATRICIA HARGER 5,780 (INCLUDED IN DEFERRED COMPENSATION) AHMED EBEID 29,078 (INCLUDED IN DEFERRED COMPENSATION) AMR HEGAZI 18,577 (INCLUDED IN DEFERRED COMPENSATION) NICOLE VANDERHEYDEN 27,698 (INCLUDED IN DEFERRED COMPENSATION) NANCY BOUTIN 14,498 (INCLUDED IN DEFERRED COMPENSATION) TRACY TAGGART 19,718 (INCLUDED IN DEFERRED COMPENSATION) |
| PART I, LINE 6 | CERTAIN PHYSICIANS RECEIVE INCENTIVE COMPENSATION IN ACCORDANCE WITH THEIR EMPLOYMENT AGREEMENTS WITH SALEM HOSPITAL. AMOUNTS NOTED ON SCHEDULE J PART II COLUMN (II) REFLECT PAYMENTS EARNED BY THESE PHYSICIAN EMPLOYEES IN SUCH AGREEMENTS. |
| PART I, LINE 7 | THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES, IN CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, REVIEWS CEO TOTAL COMPENSATION AND PERFORMANCE ANNUALLY. AS PART OF THE COMMITTEE'S ACTIONS, A NON-FIXED BONUS MAY BE AWARDED TO THE CEO. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| THE HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM OREGON REVENUE BONDS | |||||||
| 521542796 | 794458CL1 | 2006-11-15 | 123122698 | QUALIFIED HOSPITAL BOND | 0 | 0 | 0 |
| THE HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM OREGON REVENUE BONDS | |||||||
| 521542796 | 794458CZ0 | 2008-11-13 | 125000000 | QUALIFIED HOSPITAL BOND | 0 | 0 | 0 |
| THE HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM OREGON REVENUE BONDS | |||||||
| 521542796 | 794458CX5 | 2008-10-08 | 60487711 | QUALIFIED HOSPITAL BOND | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Credit EnhancementCreditEnhancement | Other Spent ProceedsOtherSpentProceeds | Amount In Reserve FundAmountInReserveFund |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1460000 | 128355347 | 1105000 | 127250347 | 2009 | 0 | 0 | 1 | 1 | |||
| 125021764 | 633004 | 9260268 | 2009 | 1 | 0 | 0 | 1 | 1153592 | 113975 | ||
| 60529178 | 837899 | 6160859 | 2009 | 1 | 0 | 1 | 1 | 47525000 | 6005354 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 1 | 1 | 1 | 0.04400 | 0.04400 | 1 |
| 0 | 0 | 1 | 1 | 1 | 0.00200 | 0.00200 | 1 |
| 0 | 0 | 1 | 1 | 1 | 0.01800 | 0.01800 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Business Name Line2NameOfGICProvider/BusinessNameLine2 | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WELLS FARGO BANK | |||||||||||
| 0 | 0 | 0 | 1 | NA | 2.000000000000 | 1 | 0 | 1 | |||
| UBS AG | |||||||||||
| 0 | 1 | 1 | 0 | 0 | 1 | 25.800000000000 | 0 | 0 | |||
| (no name) | |||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | ||||||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE 990. IT IS THEN FORWARDED TO THE ENTIRE BOARD OF TRUSTEES. | |
| ON AN ANNUAL BASIS THE SECRETARY OF THE HOSPITAL SHALL SEND TO EACH PERSON WHO IS A TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE, AND TO THOSE EMPLOYEES OF THE HOSPITAL AS THE BOARD MAY DETERMINE, A COPY OF THE POLICY REGARDING CONFLICTS OF INTEREST, TOGETHER WITH A QUESTIONNAIRE INQUIRING AS TO CONFLICTS, TO BE COMPLETED A AND RETURNED TO THE SECRETARY BY THE TRUSTEE, OFFICER, COMMITTEE MEMBER OR EMPLOYEE PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR. | FORM 990, PART VI, SECTION B, LINE 12C | |
| EXECUTIVE COMPENSATION AT SALEM HOSPITAL IS DESIGNED TO ALLOW THE ORGANIZATION TO RECRUIT AND RETAIN QUALIFIED SENIOR LEADERS. THE GOVERNANCE COMMITTEE OF THE SALEM HOSPITAL BOARD OF TRUSTEES, NONE OF WHOM IS A SALEM HOSPITAL EMPLOYEE, ENGAGES ONE OR MORE INDEPENDENT CONSULTANTS TO PROVIDE MARKET DATA ON EXECUTIVE COMPENSATION, INCLUDING BENEFITS, FOR THE CEO AND OTHER EXECUTIVES IN SIMILAR ROLES AT COMPARABLE ORGANIZATIONS. THIS INFORMATION IS USED BY THE GOVERNANCE COMMITTEE IN ITS DISCUSSIONS AND DECISIONS ON CEO COMPENSATION. THE CEO, IN CONJUNCTION WITH OTHER SALARY SURVEY OR PUBLIC INFORMATION AND THE INDEPENDENT CONSULTANT, ENSURES THAT EACH EXECUTIVE'S COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE ON THE HOSPITAL WEBSITE. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -11,566,383. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -3,490,707. CHANGE IN NET BENEFIT COST -666,155. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION -118,601. GAIN ON DISCONTINUED OPERATIONS 388,729. EQUITY TRANSFERS -3,306,667. TOTAL TO FORM 990, PART XI, LINE 5: -18,759,784. | FORM 990, PART XI, LINE 5: |
| NO CHANGE FROM PRIOR YEAR. | FORM 990, PART XII, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MWVP INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 570 LIBERTY ST SE STE 200 | AddressLine1 |
| City | SALEM | City |
| State | OR | State |
| ZIP Code | 97301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 123456789 | EIN |
| Primary Activities | HOLDS LAND | PrimaryActivities |
| Legal Domicile State | OR | LegalDomicileState |
| Total Income | 0 | TotalIncome |
| EOY Assets | 5128708 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM HEALTH | BusinessNameLine1 |
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 FOUNDATION | |||||||||||
| 890 OAK STREET SE | SALEM | OR | 97301 | 237002687 | SUPPORTS SALEM HOSPITAL | OR | 501(C)(3) | 7 | 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 PROFESSIONAL FEES | OR | 501(C)(3) | 3 | SALEM HEALTH | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OREGON COMMUNITY IMAGING LLC | |||||||||||||
| 2925 RYAN DR SE | SALEM | OR | 97301 | 202683062 | MEDICAL IMAGING COOPERATIVE | OR | SALEM HOSPITAL | RELATED | -31420 | 19263 | 0 | 1 | 0.50000 |
| SALEM CARDIO DIAGNOSTICS | |||||||||||||
| 665 WINTER STREET SE | SALEM | OR | 97301 | 930579722 | CARDIO DIAGNOSTICS | OR | SALEM HOSPITAL | RELATED | 0 | 1 | 1.00000 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | 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 | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | 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 | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| SALEM HOSPITAL FOUNDATION | |
| C | 1281110 |
| WILLAMETTE VALLEY PROFESSIONAL SERVICES | |
| O | 1198993 |
| WEST VALLEY HOSPITAL | |
| D | 3902837 |
| WEST VALLEY HOSPITAL | |
| P | 1687821 |
| SALEM HOSPITAL FOUNDATION | |
| P | 450486 |
| WILLAMETTE VALLEY PROFESSIONAL SERVICES | |
| Q | 3306667 |
| WILLAMETTE VALLEY INSURANCE COMPANY | |
| P | 292826 |
| WILLAMETTE VALLEY INSURANCE COMPANY | |
| Q | 2000000 |