MID-COLUMBIA MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MID-COLUMBIA MEDICAL CENTER (EIN 93-0386936)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201203199349306400
Schema version
2011v1.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T16:28:35-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN930418710EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELAP LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15885 MEADOWS ROAD NO 200AddressLine1
CityLAKE OSWEGOCity
StateORState
ZIP Code97035ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930386936EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MID-COLUMBIA MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMID-NameControl
Phone5412961111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11700 E 19TH STREETAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDUANE FRANCISName
TitleCEOTitle
Phone5412961111Phone
Date Signed2012-11-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWESLEY B HANSENName
PTINP00226581PTIN
Phone5036974118Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDUANE FRANCISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11700 E 19TH STREETAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode
FieldValueIRS element (for citing)
Gross Receipts107966920GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MCMC.NETWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees1021TotalNbrEmployees
Total Nbr Volunteers190TotalNbrVolunteers
Total Gross UBI37191TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2268291ContributionsGrantsPriorYear
Contributions Grants Current Year254973ContributionsGrantsCurrentYear
Program Service Revenue Prior Year95355581ProgramServiceRevenuePriorYear
Program Service Revenue CY102147973ProgramServiceRevenueCY
Investment Income Prior Year136811InvestmentIncomePriorYear
Investment Income Current Year47588InvestmentIncomeCurrentYear
Other Revenue Prior Year2610682OtherRevenuePriorYear
Other Revenue Current Year4023480OtherRevenueCurrentYear
Total Revenue Prior Year100371365TotalRevenuePriorYear
Total Revenue Current Year106474014TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year31064GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY71490GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year55131286SalariesEtcPriorYear
Salaries Etc Current Year60174642SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year43088780OtherExpensePriorYear
Other Expenses Current Year42773432OtherExpensesCurrentYear
Total Expenses Prior Year98251130TotalExpensesPriorYear
Total Expenses Current Year103019564TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2120235RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3454450RevenuesLessExpensesCY
Total Assets BOY48079159TotalAssetsBOY
Total Assets EOY54284002TotalAssetsEOY
Total Liabilities BOY20916759TotalLiabilitiesBOY
Total Liabilities EOY23747668TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY27162400NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30536334NetAssetsOrFundBalancesEOY
Mission DescriptionACUTE CARE HOSPITAL - SEE SCH OMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense95861507Expense
Grants71490Grants
Revenue105242640Revenue
DescriptionACUTE HOSPITAL CARE: INPATIENT DAYS 7,255 INPATIENT REHAB DAYS 1,027, OUTPATIENT OBSERVATION DAYS 1,677, LABORATORY TESTS 201,394, IMAGING TESTS 28,920, HOME HEALTH EPISODES 1,425, EMERGENCY VISITS 16,341, MEDICAL ONCOLOGY 10,061, OUTPATIENT SURGERIES 2,103, RADIATION ONCOLOGY OUTPATIENT PROCEDURES 9,613, TOTAL OUTPATIENTS 123,746.SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS.Description
Total Program Service Expense95861507TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096154NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1021NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MID-COLUMBIA MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5412961111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11700 E 19TH STREETAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CARINA SCHMIDT
CHAIR1.00X000
GRETCHEN KIMSEY
DIRECTOR1.00X000
DAN BOLDT
VICE CHAIR1.00X000
ROBERT L R BAILEY
DIRECTOR1.00X000
WALLACE WOLF JR DVM
SECRETARY1.00X000
PAUL CARDOSI
DIRECTOR50.00X173370021429
DUANE FRANCIS
PRESIDENT & CEO50.00X0483759130991X
ROB CARNAHAN
DIRECTOR1.00X000
DONALD ARBON
CFO & VP FINANCE50.00022007426200X
REGINA ROSE
VP - CHIEF NURSING OFFICER50.00157814024973X
WILLIAM HAMILTON
VP - MEDICAL AFFAIRS50.00315090027557X
XINYU FU
PHYSICIAN50.00390362030512X
JOHN SCHWARTZ
PHYSICIAN50.00542648026912X
CARL SCHWARTZ
PHYSICIAN50.00388542023957X
MARC MCALLISTER
PHYSICIAN50.00377375031018X
GARY GINGRICH
PHYSICIAN50.00567123025525X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2912324TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs703833TotalReportableCompFrmRltdOrgs
Total Other Compensation369074TotalOtherCompensation
Number Individuals GT100 K73NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
COLUMBIA GORGE PATHOLOGY ASSN
1700 E 19TH STTHE DALLESOR97058PATHOLOGY1134673
RADIATION ONCOLOGISTS PC
1400 NW IRVING ST SUITE 527PORTLANDOR97209MEDICAL SERVICES809439
PATRICK GRIMSLEY
1700 E 19TH STTHE DALLESOR97058EMERGENCY ROOM PHYSICIAN332711
JOHN ELLIOT MD
1700 E 19TH STTHE DALLESOR97058MEDICAL SERVICES305981
BBG MARKETING
950 SE OAK AVEROSEBURGOR97470PUBLIC RELATIONS305127
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations253853RelatedOrganizations
All Other Contributions1120AllOtherContributions
Total Contributions254973TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PMNT900099103712659103712659
HOSPITAL REVENUE9000997376958573769585
CLINIC REVENUE9000991305118113051181
LESS:CONTRACTUALS-HOSP900099-88385452-88385452
FieldValueIRS element (for citing)
Total Program Service Revenue102147973TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column38229TotalRevenueColumn
Exclusion$38,229ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column299TotalRevenueColumn
Related Or Exempt Function Income299RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1502265Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1492906Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities9359Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column9359TotalRevenueColumn
Exclusion$9,359ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
DAYCARE624410456206$456,206
CAFETERIA722100435416$435,416
LAUNDRY8123003719137191

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column3094368TotalRevenueColumn
Related Or Exempt Function Income3094368RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue4023181TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column106474014TotalRevenueColumn
Related Or Exempt Function Income105242640RelatedOrExemptFunctionIncome
Unrelated Business Revenue37191UnrelatedBusinessRevenue
Exclusion$939,210ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total71490Total
Program Services71490ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total700933Total
Program Services475461ProgramServices
Management And General225472ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total47712559Total
Program Services45659123ProgramServices
Management And General2053436ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2375409Total
Program Services2220820ProgramServices
Management And General154589ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6073677Total
Program Services5678408ProgramServices
Management And General395269ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3312064Total
Program Services3096518ProgramServices
Management And General215546ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1500000Total
Management And General1500000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total370346Total
Management And General370346ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total128533Total
Management And General128533ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3975012Total
Program Services3869475ProgramServices
Management And General105537ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total674282Total
Program Services617826ProgramServices
Management And General56456ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total455625Total
Program Services455625ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2911518Total
Program Services2821248ProgramServices
Management And General90270ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total891454Total
Program Services850266ProgramServices
Management And General41188ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES119747701190420570565
PURCHASED SERVICES605012047605091289611
MEDICAL PROF. FEES5327007523100796000
BAD DEBT EXPENSE456696345627464217

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3947802Total
Program Services3586780ProgramServices
Management And General361022ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total103019564Total
Program Services95861507ProgramServices
Management And General7158057ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4889659BOY
EOY9641349EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12527756BOY
EOY12437320EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1828326BOY
EOY1624701EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1444501BOY
EOY1349038EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis59709448LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec41894612LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY16560914BOY
EOY17814836EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10828003BOY
EOY11416758EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY48079159BOY
EOY54284002EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8344130BOY
EOY8542141EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY9967074BOY
EOY10915152EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2605555BOY
EOY4290375EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY20916759BOY
EOY23747668EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26792269BOY
EOY30256427EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY370131BOY
EOY279907EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27162400BOY
EOY30536334EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY48079159BOY
EOY54284002EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3454450ReconcilationRevenueExpenses
Reconcilation Other Changes-80516ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1278290BeginningOfYearBalance
Contributions413749Contributions
Investment Earnings Or Losses6603InvestmentEarningsOrLosses
Grants Or Scholarships438261GrantsOrScholarships
End Of Year Balance1260381EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance357664BeginningOfYearBalance
Contributions32657Contributions
Investment Earnings Or Losses402InvestmentEarningsOrLosses
Grants Or Scholarships23127GrantsOrScholarships
End Of Year Balance367596EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance358543BeginningOfYearBalance
Contributions13818Contributions
Investment Earnings Or Losses890InvestmentEarningsOrLosses
Grants Or Scholarships15587GrantsOrScholarships
End Of Year Balance357664EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance347617BeginningOfYearBalance
Contributions10659Contributions
Investment Earnings Or Losses6106InvestmentEarningsOrLosses
Grants Or Scholarships5839GrantsOrScholarships
End Of Year Balance358543EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.64410BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.06920PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.28670TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R0AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis212933OtherCostOrOtherBasis
Book Value212933BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12673142OtherCostOrOtherBasis
Depreciation8115728Depreciation
Book Value4557414BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2990040OtherCostOrOtherBasis
Depreciation190076Depreciation
Book Value2799964BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis42796868OtherCostOrOtherBasis
Depreciation32845604Depreciation
Book Value9951264BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1036465OtherCostOrOtherBasis
Depreciation743204Depreciation
Book Value293261BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings17814836TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
OTHER ASSETS3375331
BOARD DESIGNATED ASSETS - CASH & MONEY MARKET5753088
BOARD DESIGNATED ASSETS - CERTIFICATES OF DEPOSIT350831
BOARD DESIGNATED ASSETS - MUTUAL FUNDS1278302
BOARD DESIGNATED ASSETS - ACCRUED INTEREST RECEIVABLE930
INTEREST IN NET ASSETS OF MC FOUNDATION279907
DUE FROM AFFILIATE378369
FieldValueIRS element (for citing)
Total Book Value Other Assets11416758TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
CAPITAL LEASES$998,401
OTHER LIABILITIES$1,608,976
SETTLEMENT RESERVES$1,113,113
DEFERRED COMPENSATION$569,885
FieldValueIRS element (for citing)
Total Of Amounts4290375TotalOfAmounts
Total Revenue106474014TotalRevenue
Total Expenses103019564TotalExpenses
Excess Or Deficit For Year3454450ExcessOrDeficitForYear
Net Unrealized GL On Investments9708NetUnrealizedGLOnInvestments
Other-$90,224OtherAmount
Total Adjustments-80516TotalAdjustments
Excess Or Deficit Per FS3373934ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt106229869TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments9708NetUnrealizedGainsInvestments
Revenue Not Rptd F9909708RevenueNotRptdF990
Revenue Subtotal106220161RevenueSubtotal
Other Revenues Not Included253853OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt253853RevenueNotRptdOnFinStmt
Total Revenue Per Form990106474014TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt102563939TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal102563939ExpensesSubtotal
Other Expenses Not Included455625OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt455625ExpensesNotRptdOnFinStmt
Total Expenses Per Form990103019564TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:DECREASE IN INTEREST IN NET ASSETS OF MID-COLUMBIA HEALTH FOUNDATION -90,224.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS FROM AFFILIATE 253,853.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:PAYMENTS TO AFFILIATE 455,625.
PART X, LINE 2 - FIN 48 FOOTNOTE DISCLOSURE FOR UNCERTAIN TAX POSITIONS: INCOME TAX POSITIONS THAT MEET A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE MEDICAL CENTER'S BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE MEDICAL CENTER'S STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Tailored To Ind HospitalsXPolicyTailoredToIndHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3047979TotalCommunityBenefitExpense
Net Community Benefit Expense3047979NetCommunityBenefitExpense
Percent Of Total Expense0.02960PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11310169TotalCommunityBenefitExpense
Direct Offsetting Revenue7224604DirectOffsettingRevenue
Net Community Benefit Expense4085565NetCommunityBenefitExpense
Percent Of Total Expense0.03970PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense14358148TotalCommunityBenefitExpense
Direct Offsetting Revenue7224604DirectOffsettingRevenue
Net Community Benefit Expense7133544NetCommunityBenefitExpense
Percent Of Total Expense0.06930PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense672869TotalCommunityBenefitExpense
Direct Offsetting Revenue14871DirectOffsettingRevenue
Net Community Benefit Expense657998NetCommunityBenefitExpense
Percent Of Total Expense0.00640PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense469007TotalCommunityBenefitExpense
Direct Offsetting Revenue364DirectOffsettingRevenue
Net Community Benefit Expense468643NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3415037TotalCommunityBenefitExpense
Direct Offsetting Revenue3133605DirectOffsettingRevenue
Net Community Benefit Expense281432NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense21433TotalCommunityBenefitExpense
Direct Offsetting Revenue7705DirectOffsettingRevenue
Net Community Benefit Expense13728NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense669002TotalCommunityBenefitExpense
Direct Offsetting Revenue57353DirectOffsettingRevenue
Net Community Benefit Expense611649NetCommunityBenefitExpense
Percent Of Total Expense0.00590PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5247348TotalCommunityBenefitExpense
Direct Offsetting Revenue3213898DirectOffsettingRevenue
Net Community Benefit Expense2033450NetCommunityBenefitExpense
Percent Of Total Expense0.01960PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense19605496TotalCommunityBenefitExpense
Direct Offsetting Revenue10438502DirectOffsettingRevenue
Net Community Benefit Expense9166994NetCommunityBenefitExpense
Percent Of Total Expense0.08890PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense230850TotalCommunityBuildingExpense
Direct Offsetting Revenue15903DirectOffsettingRevenue
Net Community Building Expense214947NetCommunityBuildingExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense192215TotalCommunityBuildingExpense
Net Community Building Expense192215NetCommunityBuildingExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1693TotalCommunityBuildingExpense
Net Community Building Expense1693NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense424758TotalCommunityBuildingExpense
Direct Offsetting Revenue15903DirectOffsettingRevenue
Net Community Building Expense408855NetCommunityBuildingExpense
Percent Of Total Expense0.00400PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,237,095BadDebtExpenseAmount
Amount Attributable To26592AmountAttributableTo
Amount Reimbursed By Medicare28689783AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare25162028CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall3527755MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnership
1 LONE PINE HEALTH & WELLNESS CENTER
MANAGE MEDICAL BUILDING/PROPERTY0.30000
2 HEALTH FUTURE LLC
HEALTHCARE, BENEFITS, AND ADMINISTRATIVE SERVICES PROVIDER0.14290
FieldValueIRS element (for citing)
Number Of Hospital Facilities6NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (6 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
MID-COLUMBIA MEDICAL CENTER
11700 E 19TH STREETTHE DALLESOR97058XXX
COLUMBIA HILLS FAMILY MEDICINE - RHC
21620 E 12TH STREETTHE DALLESOR97058RURAL HEALTH CLINIC
DR ALAIMO - RHC
31726 E 12TH STREETTHE DALLESOR97058RURAL HEALTH CLINIC
WATER'S EDGE CLINICS
4551 LONE PINE BLVDTHE DALLESOR97058RURAL HEALTH CLINIC
INTERNAL MEDICINE CLINIC - RHC
51815 1825 E 19TH STREETTHE DALLESOR97058RURAL HEALTH CLINIC
COLUMBIA CREST CLINIC
61935 E 19TH STREETTHE DALLESOR97058RURAL HEALTH CLINIC

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (6 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsitePosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentPermit Other ActionsPermitOtherActionsCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
MID-COLUMBIA MEDICAL CENTER
111150.0000000000001150.0000000000001XXX11XXXXXX1X01X00
COLUMBIA HILLS FAMILY MEDICINE - RHC
211150.0000000000001150.0000000000001XXX11XX001X00
DR ALAIMO - RHC
311150.0000000000001150.0000000000001XXX11XX001X00
WATER'S EDGE CLINICS
411150.0000000000001150.0000000000001XXX11XX001X00
INTERNAL MEDICINE CLINIC - RHC
511150.0000000000001150.0000000000001XXX11XX001X00
COLUMBIA CREST CLINCS
611150.0000000000001150.0000000000001XXX11XX001X00

Form990 Schedule H Part VI Form990ScheduleHPartVI (24 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: TRACK DIRECT LABOR AND OTHER COSTS IN EACH CATEGORY FOR ALL PATIENT SEGMENTS. IF ONLY REVENUE INFORMATION WAS AVAILABLE, A COST/CHARGE RATIO WAS APPLIED TO ESTIMATE COSTS.
PART I, LINE 7G: NUMBERS INCLUDE HOME HEALTH SERVICES, NET OF REVENUES AND CHARITY CARE/BAD DEBT ALREADY REPORTED IN PART I-7A OR III-A.2.$3,133,605 HOME HEALTH REVENUES$3,415,037 HOME HEALTH OPERATING EXPENSES$281,432 NET LOSSCOMMUNITY BENEFIT: MCMC IS THE SOLE PROVIDER OF VISITING HOME HEALTH SERVICES IN A FIVE-COUNTY RANGE; WITHOUT OUR SERVICES THERE WOULD BE NO IN-HOME CARE IN THE COMMUNITIES WE SERVE.
PART II: MCMC PROMOTES THE HEALTH OF THE COMMUNITIES WE SERVE BY PARTICIPATING IN REGIONAL EMERGENCY PREPAREDNESS PROGRAMS (H1N1, PANDEMIC, NATURAL DISASTERS) AND DRILLS; BY SERVING AS AN ADVOCATE FOR THE COMMUNITY WITH REGARD TO LOCAL, REGIONAL AND STATE-WIDE HEALTH INITIATIVES; ACTING IN ADVISORY CAPACITY WITH OTHER LOCAL AND REGIONAL GROUPS IN ORDER TO CREATE, ACCESS AND PROVIDE SERVICES OTHERWISE NOT AVAILABLE TO THE COMMUNITY; WORKING WITH LOCAL COMMUNITY COLLEGE AND EMS TO EDUCATE AND TRAIN FUTURE HEALTHCARE WORKERS BY PROVIDING JOB SHADOWING AND MENTORING PROGRAMS AS WELL AS DONATED SUPPORT TO THE COLLEGE FOR SPECIFIC NURSING PROGRAMS.
PART III, LINE 4: FOOTNOTE 1 IN THE AUDITED FINANCIAL STATEMENTS DESCRIBES ALLOWANCE FOR BAD DEBT EXPENSE AT GROSS CHARGE. THE ESTIMATE IS BASED PRIMARILY UPON THE MEDICAL CENTER'S HISTORICAL COLLECTION EXPERIENCE, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY, AND THE EFFECTIVENESS OF COLLECTIONS EFFORTS.BAD DEBT COST IS CALCULATED BY APPLYING THE HOSPITAL'S COST TO CHARGE RATIO.
PART III, LINE 8: MID-COLUMBIA MEDICAL CENTER CONTINUES TO PROVIDE CLINICAL SERVICES TO MEDICARE PATIENTS AT A DEFICIT AS PART OF OUR COMMITMENT TO THE RESIDENTS OF THE COMMUNITY WE SERVE. THIS DEFICIT IS CONSISTENT WITH OUR TAX-EXEMPT STATUS AND INTERNAL MISSION TO PROVIDE COMMUNITY BASED HEALTHCARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY.
PART III, LINE 9B: IN CASES WHERE PATIENT HAS QUALIFIED FOR FULL OR PARTIAL CHARITY CARE, THAT AMOUNT IS WRITTEN DOWN IN THE PATIENT ACCOUNT AND NO ATTEMPT IS MADE TO COLLECT THE AMOUNT WRITTEN DOWN.
PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED.MID-COLUMBIA MEDICAL CENTER
PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED.COLUMBIA HILLS FAMILY MEDICINE - RHC
PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED.DR. ALAIMO - RHC
PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED.WATER'S EDGE CLINICS
PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED.INTERNAL MEDICINE CLINIC - RHC
PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE; POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED.COLUMBIA CREST CLINCS
PART V, SECTION B, LINE 15E: REPORT ONLY TO THIRD PARTY COLLECTION AGENCY: ASSET RECOVERYMID-COLUMBIA MEDICAL CENTER
PART V, SECTION B, LINE 19D: DISCOUNTS OF 10% TO 20% ARE OFFERED ON THE SELF-PAY PORTION ON ANY HOSPITAL BILL. A TIMELY PAYMENT DISCOUNT IS OFFERED IN ADDITION TO THE ABOVE FOR SHORT-TERM PAYMENT PLANS. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED.MID-COLUMBIA MEDICAL CENTER
PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED.COLUMBIA HILLS FAMILY MEDICINE - RHC
PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED.DR. ALAIMO - RHC
PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED.WATER'S EDGE CLINICS
PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED.INTERNAL MEDICINE CLINIC - RHC
PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED.COLUMBIA CREST CLINCS
PART VI, LINE 2: BOARD AND SENIOR EXECUTIVE LEADERSHIP ARE ACTIVELY INVOLVED IN PRIORITIZATION OF COMMUNITY INITIATIVES. A FULL-TIME DIRECTOR OVERSEES PROJECT DEVELOPMENT AND IMPLEMENTATION OF INSTITUTIONAL PROGRAMS AND ACTS AS THE PRIMARY LIAISON IN COMMUNITY COLLABORATIONS.COMMUNITY BENEFIT PRIORITIES AND ALLOCATIONS ARE GUIDED BY A COMMUNITY ASSESSMENT PROCESS WHICH UTILIZES QUANTITATIVE AND QUALITATIVE DATA OBTAINED FROM INTERNAL SOURCES AS WELL AS ASSESSMENT DATA FROM KEY COMMUNITY PARTNERS. THESE PARTNERS INCLUDE THE NORTHERN CENTRAL PUBLIC HEALTH DEPARTMENT, WASCO COUNTY COMMISSION ON CHILDREN AND FAMILIES, THE CITY OF THE DALLES VISION ACTION PLAN AND WASCO COUNTY EMERGENCY FOOD BANKS. OREGON STATE DATA IS ALSO REVIEWED INCLUDING COUNTY SPECIFIC MORBIDITY AND MORTALITY RATES.THIS INFORMATION IS THEN REVIEWED BY THE MEMBERS OF THE HOSPITAL OPERATIONS MANAGEMENT TEAM. DISCUSSION AND RECOMMENDATION OF COMMUNITY BENEFIT FOCUS AREAS CENTERS AROUND FIVE KEY COMPONENTS: ALIGNMENT WITH THE ORGANIZATIONS STRATEGIC PLAN; LIKELIHOOD OR FEASIBILITY OF HAVING A MEASURABLE IMPACT ON THE ISSUE; ALIGNMENT WITH CORE ORGANIZATIONAL COMPETENCIES; EFFICIENT ALLOCATION OF RESOURCES AND ALIGNMENT WITH PARTNERS WHO HAVE RESOURCES ALLOCATED FOR THE ISSUE.ISSUES OF IMPORTANCE IN OUR COMMUNITY INCLUDE CHRONIC ILLNESS, PRIMARILY DIABETES, HIGH CHOLESTEROL, HYPERTENSION, AND OBESITY ALL OF WHICH ALIGN WITH OUR CORE ORGANIZATIONAL FOCUS. KEY COMMUNITY PARTNER FOCUS AREAS INCLUDE CHILD ABUSE, TEEN PREGNANCY, READINESS TO LEARN AND ALCOHOL AND TOBACCO USE IN MIDDLE AND HIGH SCHOOL STUDENT POPULATIONS. PLEASE SEE BELOW FOR HIGHLIGHTED PROGRAMS AND SERVICES ADDRESSING THESE AND OTHER GENERAL COMMUNITY HEALTH ISSUES DURING 2011.
PART VI, LINE 3: ALL FAMILY PRACTICE STAFF ACTIVELY PROMOTE HEALTHY KIDS OPTIONS, WHICH PROVIDES INSURANCE FOR ALL CHILDREN IN THE STATE OF OREGON. BROCHURES ARE AVAILABLE IN BOTH LANGUAGES AT ALL FAMILY PRACTICE OFFICES AND THE SCHOOL HEALTH NURSES PROVIDE THAT INFORMATION TO THE LOCAL SCHOOLS AS WELL.OUR PATIENT AND VISITOR SERVICES AND PATIENT ACCOUNTS DEPARTMENTS TAKE AN ACTIVE ROLE IN ASSISTING PATIENTS WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. BROCHURES (ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS. THIS BROCHURE OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION.
PART VI, LINE 4: MID-COLUMBIA MEDICAL CENTER (MCMC) IS LOCATED IN THE DALLES, WASCO COUNTY, OREGON, POPULATION 24,280. MCMC SERVES A WIDE GEOGRAPHIC AREA OF RURAL NORTH CENTRAL OREGON ALONG THE COLUMBIA RIVER WHICH SERVES AS THE DIVISION BETWEEN THE STATES OF WASHINGTON AND OREGON. THIS SERVICE AREA INCLUDES WASCO, SHERMAN AND GILLIAM COUNTIES IN OREGON AND KLICKITAT COUNTY IN WASHINGTON STATE. THE TOTAL POPULATION OF THIS SERVICE AREA, UTILIZING 2011 ESTIMATE CENSUS DATA, IS 48,544; WHITE 91%, HISPANIC/LATINO 13.2%, AMERICAN INDIAN/ALASKA NATIVE 4.3%, OTHER 1.6%. 17% OF THE POPULATION IS BELOW THE POVERTY LEVEL, 23% OF ADULTS UNDER 65 ARE UNINSURED.IN ADDITION TO THE YEAR ROUND POPULATION, THE DALLES EXPERIENCES AN INFLUX OF OVER 15,000 SEASONAL WORKERS IN SUPPORT OF THE HARVEST OF OUR AGRICULTURAL ECONOMY.
PART VI, LINE 5: MID-COLUMBIA MEDICAL CENTER IS A MISSION-DRIVEN ORGANIZATION WHOSE PURPOSE IS: TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE;TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES.PREVENTION AND EDUCATIONIN 2011, MCMC ONCE AGAIN PLAYED A KEY ROLE IN PARTNERING WITH THOSE IN OUR COMMUNITY SEEKING TO IMPROVE/ENHANCE THEIR HEALTH THROUGH LIFESTYLE CHANGES AND CHOICES. THESE ARE JUST SOME OF THE HIGHLIGHTS OF PROGRAMS MCMC SPONSORED FOR THE COMMUNITIES WE SERVE:OBESITYTHE CENTER FOR MIND AND BODY MEDICINE PARTNERED WITH LA NUESTRA COMUNIDAD SANA TO PROVIDE EXPERT INSTRUCTORS FOR A FAMILY WEIGHT LOSS PROGRAM. 23 FAMILIES PARTICIPATED AND GRADUATED FROM THIS BENCHMARK PROGRAM ADDRESSING NUTRITION AND OBESITY IN THE HISPANIC/LATINO POPULATION, WITH SCHOLARSHIPS PROVIDED TO PARTICIPANTS UNABLE TO COVER THE EXPENSE OF THE PROGRAM.HYPERTENSIONMORE THAN 100 BLOOD PRESSURE CHECKS AND AN ARRAY OF OTHER SCREENINGS WERE PERFORMED AT THE 2011 MCMC HEALTH FAIR. BLOOD PRESSURE CHECKS ARE AVAILABLE DAILY AT THE PLANETREE HEALTH RESOURCE LIBRARY.DIABETESDIABETES DISCOVERY DAY - OVER 300 PEOPLE FROM COMMUNITIES THROUGHOUT THE COLUMBIA GORGE ATTENDED AND WERE SCREENED AT THE DIABETES DISCOVERY DAY, A FREE ANNUAL EVENT SPONSORED BY MCMC. FREE SCREENINGS BY THE LION'S CLUB MOBILE SCREENING UNIT WERE AVAILABLE, ALONG WITH DOCTORS, NURSES, PHARMACISTS AND NUTRITION EXPERTS WHO SPOKE ABOUT THE LATEST RESEARCH, TREATMENTS AND ADVANCES. VARIOUS VENDORS/DISPLAYS AND INFORMATIVE SPEAKERS PROVIDED INFORMATION ALONG WITH A DISPLAY OF DIABETIC SUPPLIES, MANAGEMENT PRODUCTS AND SCREENING.HEART DISEASE/HIGH CHOLESTEROLMCMC SPONSORS AN ANNUAL GO RED FOR WOMEN DAY WHICH PROVIDES INFORMATION ON HEART DISEASE, NUTRITION FOR HEALTHY HEARTS, BMI SCREENING, BLOOD PRESSURE CHECKS AND OVERALL HEART HEALTH EDUCATION TO OVER 500 COMMUNITY MEMBERS.CHILD ABUSESUBSIDY OF THE FAMILIES FIRST HOME VISITING PROGRAM, WHICH PROVIDES INTENSIVE PARENTING SUPPORT FOR FAMILIES AT RISK FOR CHILD ABUSE PROVIDED FUNDS FOR AN ADDITIONAL FTE ELIMINATING ANY WAITING LIST FOR FAMILIES REQUESTING THIS PROGRAM. OUR CONTINUED SUPPORT OF THIS PROGRAM HAS RESULTED IN A FOUR-YEAR TREND OF DECREASED CHILD ABUSE RATES IN WASCO COUNTY.OTHERMORE THAN 200 INDIVIDUALS ATTENDED PLANETREE HEALTH RESOURCE CENTERS (PHRC) POPULAR FREE LECTURE SERIES AND AN ADDITIONAL 6,300 RESIDENTS VISITED THE CENTER IN DOWNTOWN THE DALLES TO TAKE ADVANTAGE OF ITS VAST COLLECTION OF CONSUMER HEALTH INFORMATION.THE MCMC HEALTH AND WELLNESS FAIR PROVIDES AN OPPORTUNITY FOR COMMUNITY RESIDENTS TO LEARN HEALTH SERVICES IN THE AREA, MEET PROVIDERS AND RECEIVE FOCUSED INFORMATION ON VARIOUS TOPICS SELECTED ANNUALLY. BLOOD PRESSURE, DEPRESSION, BMI SCREENING AND DISCOUNTED LAB TESTS ARE OFFERED IN AN EFFORT TO IDENTIFY HEALTH ISSUES WHICH COULD IMPACT A HEALTHY LIFESTYLE.CAR SEAT EVALUATIONS, BIKE HELMET PROGRAMS AND TRAUMA NURSES TALK TOUGH SESSIONS ARE OFFERED ANNUALLY AT MAJOR MCMC EVENTS.MCMC FAMILY PRACTICE PROVIDERS PROVIDED OVER 300 FREE SPORTS PHYSICALS TO NOTHERN WASCO COUNTY SCHOOL DISTRICT 21 STUDENTS IN MIDDLE AND HIGH SCHOOL.MCMC PRODUCES A QUARTERLY HEALTH MAGAZINE, WELL AWARE, WHICH IS DISTRIBUTED TO OVER 17,000 HOUSEHOLDS THROUGHOUT THE SURROUNDING COMMUNITY, AT A COST OF APPROXIMATELY $100,000.MCMC FACILITATES A VARIETY OF SUPPORT GROUPS OPEN TO THE COMMUNITY ON A REGULAR BASIS, INCLUDING: MONTHLY DIABETES SUPPORT GROUP FACILITATION; MONTHLY STROKE CLUB; MONTHLY FAMILY SUPPORT CLASSES; HEALTHY WEIGHT SOLUTIONS; MONTHLY PROSTATE CANCER SUPPPORT GROUP; REACH FOR RECOVERY - BREAST CANCER SUPPORT GROUP.MEANINGFUL CONTRIBUTIONS IN THE YEAR 2011OVER 3,100 HOURS OF FREE INTERPRETIVE SERVICES WERE PROVIDED TO ASSIST PATIENTS SEEKING CARE THROUGHOUT OUR ORGANIZATION AND TO ANY OTHER LOCAL HEALTH SERVICE PROVIDER, REGARDLESS OF AFFILIATION WITH MCMC.SUBSIDY OF THE SCHOOL HEALTH SERVICES PROGRAM PROVIDES ADDITIONAL DIRECT SERVICE HOURS TO SERVE SPECIAL NEEDS STUDENTS IN THE LOCAL DISTRICT.MCMC CONDUCTS MENTORING AND INTERNSHIP PROGRAMS DESIGNED TO HELP TRAIN EXISTING AND FUTURE CARE PROVIDERS SUCH AS PHARMACY TECHNICIANS, MEDICAL ASSISTANTS, CHILD CARE PROVIDERS, RADIOLOGICAL TECHNICIANS, NURSES AND RURAL HEALTH EMS PROVIDERS. IN ADDITION, MCMC IS INVOLVED IN A VARIETY OF COMMUNITY AND COALITION BUILDING ACTIVITIES AND HEALTH ADVOCACY THROUGH ITS PARTICIPATION IN LOCAL AND STATE BOARDS. THROUGH THESE AND MANY ONGOING ACTIVITIES, MID-COLUMBIA MEDICAL CENTER CONTINUES WORKING FOR HEALTHIER COMMUNITIES.
ORREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantIRC SectionIRCSection
WASCO COUNTY
511 WASHINGTON ST STE 207THE DALLESOR9705893600231512000CAWEM PRE-NATAL EXPANSION PROJECT SHARE OF STATE TITLE XXI MATCH
MID-COLUMBIA HEALTH FOUNDATION
1700 E 19TH STREETSTHE DALLESOR970589308544335000TO PROVIDE FUNDS FOR SCHOLARSHIPS.501(C)(3)
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PAUL CARDOSI
1607060564012100096760117530194799000
DUANE FRANCIS
04837590000099572031419061475000
DONALD ARBON
02200740000013206012994024627400
REGINA ROSE
1578140000096450153280182787000
WILLIAM HAMILTON
31509000000147000128570342647000
XINYU FU
39036200000147000158120420874000
JOHN SCHWARTZ
507648035000000147000122120569560000
CARL SCHWARTZ
35354203500000014700092570412499000
MARC MCALLISTER
37737500000147000163180408393000
GARY GINGRICH
528756000383670134150121100592648000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 4BDUANE FRANCIS - $84,872
PART I, LINE 6THE INCENTIVE COMPENSATION PLAN OF $564 FOR THE QUALIFIED PERSONS WAS BASED LARGELY ON NET PROFESSIONAL FEES.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonMIRIAM D MCDONELLNamePerson
FieldValueIRS element (for citing)
RelationshipSPOUSE OF PAUL CARDOSI, DIRECTORRelationship
Amount Of Transaction69964AmountOfTransaction
Description Of TransactionEMPLOYMENTDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6HEALTH CARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF THE RETURN IS SUBMITTED TO THE BOARD OF DIRECTORS FOR REVIEW. UPDATES ARE MADE AS NECESSARY BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12CWE ANNUALLY REQUIRE ALL OFFICERS AND DIRECTORS TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR AN EMPLOYEE OR DIRECTOR WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE INDIVIDUAL COULD REMAIN AN EMPLOYEE OR DIRECTOR. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY WITH EMPLOYEES AS PART OF THE PERFORMANCE REVIEW PROCESS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS JUST DESCRIBED AND THEN VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. THE COMPENSATION OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES IS DETERMINED USING A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19AS REQUESTED.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 9,708. DECREASE IN INTEREST IN NET ASSETS OF MID-COLUMBIA HEALTH FOUNDATION -90,224. TOTAL TO FORM 990, PART XI, LINE 5: -80,516.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2CTHE RESPONSIBILITY AND PROCESS FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR.ORGANIZATIONAL OVERSIGHT OF FINANCIAL STATEMENT AUDIT:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MID-COLUMBIA HEALTH FOUNDATION
1700 E 19TH STREETTHE DALLESOR97058930854433SUPPORT MID-COLUMBIA MEDICAL CENTEROR501(C)(3)7HEALTH CARE FOR THE MID-COLUMBIA REGION0
HEALTH CARE FOR THE MID-COLUMBIA REGION
1700 E 19TH STREETTHE DALLESOR97058930847905HEALTH CARE SERVICESOR501(C)(3)3HEALTH CARE FOR THE MID-COLUMBIA REGION0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1LONE PINE HEALTH & WELLNESS CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1201 OSPREY LANE WAddressLine1
CityTHE DALLESCity
StateORState
ZIP Code97058ZIPCode
FieldValueIRS element (for citing)
EIN263919508EIN
Primary ActivityMANAGE MEDICAL BUILDING/PROPERTYPrimaryActivity
Legal Domicile StateORLegalDomicileState
Predominant Income TypeEXCLUDED 512-514PredominantIncomeType
Share Of Total Income-26764ShareOfTotalIncome
Share Of EOY Assets1143822ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.30000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
DRY HOLLOW PROFESSIONAL CENTER INC
1700 EAST 19TH STREETTHE DALLESOR97058930631350RENTAL BUILDINGORHEALTH CARE FOR THE MID-COLUMBIA REGIONC
MID-COLUMBIA HEALTH SERVICES
1700 EAST 19TH STREETTHE DALLESOR97058930840781MEDICAL BILLINGORHEALTH CARE FOR THE MID-COLUMBIA REGIONC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MID-COLUMBIA HEALTH FOUNDATION
B455625SERVICE AGREEMENT
MID-COLUMBIA HEALTH FOUNDATION
C253853CASH CONTRIBUTION RECEIVED
MID-COLUMBIA HEALTH FOUNDATION
D74717LOANS TO RELATED PARTY
HEALTH CARE FOR THE MID-COLUMBIA REGION
E81201PAYABLES TO RELATED PARTY
HEALTH CARE FOR THE MID-COLUMBIA REGION
J116145RENTAL AGREEMENT
HEALTH CARE FOR THE MID-COLUMBIA REGION
L1500000MANAGEMENT CONTRACT
MID-COLUMBIA HEALTH FOUNDATION
N299992EMPLOYEE GROSS PAY
MID-COLUMBIA HEALTH FOUNDATION
O149187ACTUAL EXPENSES

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