GOOD SAMARITAN HOSPITAL CORVALLIS: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: GOOD SAMARITAN HOSPITAL CORVALLIS (EIN 93-0391573)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-13
IRS object ID: 201213189349304681
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-11-13T16:54:48-06:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	930623286	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AKT LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	5665 SW MEADOWS RD SUITE 200	AddressLine1
City	LAKE OSWEGO	City
State	OR	State
ZIP Code	97035	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	930391573	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN HOSPITAL CORVALLIS	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	GOOD	NameControl
Phone	5417684773	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	C/O SHS ACCOUNTING PO BOX 3000	AddressLine1
City	CORVALLIS	City
State	OR	State
ZIP Code	973393000	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DANIEL B SMITH	Name
Title	VP FINANCE/CFO	Title
Phone	5417684773	Phone
Date Signed	2012-11-08	DateSigned
Authorize Third Party	0	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JOYLYN ANKENEY	Name
PTIN	P00366587	PTIN
Phone	5036204489	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN REGIONAL MEDICAL CTR	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	STEVEN W JASPERSON	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	3600 NW SAMARITAN DR	AddressLine1
City	CORVALLIS	City
State	OR	State
ZIP Code	97330	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	331424632	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.SAMHEALTH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1948	YearFormation
State Legal Domicile	OR	StateLegalDomicile
Activity Or Mission Description	GOOD SAMARITAN HOSPITAL, CORVALLIS (GSH) ACHIEVES ITS MISSION OF IMPROVING THE HEALTH AND WELL BEING OF THE COMMUNITY THROUGH ITS MEDICAL AND SURGICAL HOSPITAL AND HEALTHCARE CLINICS PROVIDING OUTPATIENT CARE SERVICES AT SEVERAL AREA LOCATIONS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	12	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	2099	TotalNbrEmployees
Total Nbr Volunteers	251	TotalNbrVolunteers
Total Gross UBI	1201837	TotalGrossUBI
Net Unrelated Business Txbl Income	-38471	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1850641	ContributionsGrantsPriorYear
Contributions Grants Current Year	475861	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	310274725	ProgramServiceRevenuePriorYear
Program Service Revenue CY	326487593	ProgramServiceRevenueCY
Investment Income Prior Year	598535	InvestmentIncomePriorYear
Investment Income Current Year	598145	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2368336	OtherRevenuePriorYear
Other Revenue Current Year	2707367	OtherRevenueCurrentYear
Total Revenue Prior Year	315092237	TotalRevenuePriorYear
Total Revenue Current Year	330268966	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	283825	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	279287	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	162291614	SalariesEtcPriorYear
Salaries Etc Current Year	174410975	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	252344	TotalFundrsngExpCurrentYear
Other Expense Prior Year	145888204	OtherExpensePriorYear
Other Expenses Current Year	154878894	OtherExpensesCurrentYear
Total Expenses Prior Year	308463643	TotalExpensesPriorYear
Total Expenses Current Year	329569156	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	6628594	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	699810	RevenuesLessExpensesCY
Total Assets BOY	183573666	TotalAssetsBOY
Total Assets EOY	184278626	TotalAssetsEOY
Total Liabilities BOY	76799467	TotalLiabilitiesBOY
Total Liabilities EOY	90912653	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	106774199	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	93365973	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	GOOD SAMARITAN HOSPITAL, CORVALLIS (GSH) IS A MEMBER OF SAMARITAN HEALTH SERVICES (SHS), A REGIONAL NETWORK OF HOSPITALS, PHYSICIANS AND SENIOR CARE FACILITIES. THE NETWORK, FORMED IN THE LATE 1990'S, SERVES APPROXIMATELY 290,000 RESIDENTS IN LINN, BENTON, LINCOLN AND PORTIONS OF POLK AND MARION COUNTIES IN OREGON. IT IS LOCALLY OWNED, AND ITS BOARDS OF DIRECTORS INCLUDE HOSPITAL LEADERS, PHYSICIANS AND COMMUNITY REPRESENTATIVES. GSH PROVIDES HEALTHCARE SERVICES REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, DISABILITY OR AGE. THE MISSION OF GSH IS TO ENHANCE COMMUNITY HEALTH AND ACHIEVE HIGH VALUE THROUGH QUALITY SERVICES ACROSS A CONTINUUM OF CARE. THE COLLECTIVE VISION OF THE SHS SYSTEM IS TO BE A VALUES-DRIVEN ORGANIZATION GOVERNED BY COMMUNITY MEMBERS, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. SHS SEEKS TO BE THE FIRST CHOICE OF CONSUMERS IN THE REGION AND TO LEAD COLLABORATIVE EFFORTS AMONG THOSE WHO SHARE SIMILAR GOALS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	282087781	Expense
Revenue	325642209	Revenue
Description	GOOD SAMARITAN HOSPITAL CORVALLIS (GSH), THE LARGEST HOSPITAL IN LINN, BENTON AND LINCOLN COUNTIES, OFFERS MORE THAN 22 MEDICAL SPECIALTIES INCLUDING COMPREHENSIVE CANCER CARE, A FULL-SERVICE CARDIOLOGY AND VASCULAR SURGERY PROGRAM, A SLEEP LAB, NEUROSURGERY AND OTHER REGIONAL SERVICES. GSH HAS MORE THAN 1,800 EMPLOYEES AND 200 VOLUNTEERS SERVING THE MEDICAL NEEDS OF THE COMMUNITY. IT IS LICENSED TO OPERATE 188 BEDS AND IS ONE OF ONLY THREE 'LEVEL 2' TRAUMA CENTERS IN THE STATE. DURING 2011, GSH SERVED 9,626 INPATIENTS, HAD 23,213 EMERGENCY DEPARTMENT VISITS, PERFORMED 10,873 SURGERIES AND DELIVERED 1,063 BABIES. IN ADDITION, GSH PERFORMED 71,529 IMAGING PROCEDURES, HAD 33,788 HOME HEALTH VISITS, AND HAD 175,611 PHYSICIAN CLINIC VISITS.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	279287	Expense
Grants	279287	Grants
Description	GRANTS AND ASSISTANCE PROVIDED BY GOOD SAMARITAN HOSPITAL CORVALLIS TO VARIOUS ORGANIZATIONS AND INDIVIDUALS TO BENEFIT THE COMMUNITY. SEE PART IX, LINES 1 AND 2 AND RELATED SCHEDULE I FOR MORE DETAILS.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	282367068	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	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	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	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	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	1	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	7	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	2099	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	1	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	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	0	CompensationProcessCEO
Compensation Process Other	0	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	SAMARITAN HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5417684773	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 3000	AddressLine1
City	CORVALLIS	City
State	OR	State
ZIP Code	973393000	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 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
BISHOP MICHAEL HANLEY
BOARD MEMBER	1.00	X	0	0	0
JAY MCHENRY
BOARD MEMBER	1.00	X	0	0	0
NANCY SEIFERT
BOARD MEMBER	1.00	X	0	0	0
GILBERT BECK
BOARD TREASURER	1.00	X	0	0	0	X
CLIFFORD A HALL MD
BOARD MEMBER/PHYSICIAN	8.00	X	18610	0	0
RICHARD CRONK MD
BOARD SECRETARY	1.00	X	0	0	0	X
REVEREND SIMON JUSTICE
BOARD MEMBER	1.00	X	0	0	0
CARLYN ROY
BOARD SECRETARY	1.00	X	0	0	0	X
SHIRLEY PETERSON
BOARD CHAIR	1.00	X	0	0	0	X
JUDY LIST
BOARD VICE-CHAIR	1.00	X	0	0	0	X
ERIC THOMPSON
BOARD MEMBER	1.00	X	0	0	0
FREDERICK WEISENSEE MD
BOARD MEMBER/PHYSICIAN	40.00	X	306313	0	39193
TIM HENNESSY
BOARD MEMBER	1.00	X	0	0	0
STEVEN W JASPERSON
CEO	40.00		0	434923	65366	X
DANIEL B SMITH
VP FINANCE/CFO	8.00		0	320608	51431	X
KATHRYN M HALE
VP NURSING	40.00		175948	0	44618		X
MICHAEL A MAY MD
VP SMH MEDICAL DIRECTOR	40.00		296349	0	67382		X
SCOTT WILSON
VP ANCILLARY & SUPPORT SERVICES	40.00		160067	0	36598		X
STEVEN GOODWIN MD
PHYSICIAN	40.00		632936	0	44030			X
DONALD PENNINGTON DO
PHYSICIAN	40.00		852868	0	51642			X
TOSHIO NAGAMOTO MD
PHYSICIAN	40.00		746778	0	49158			X
RANDALL V BREAM MD
PHYSICIAN	40.00		611665	0	41169			X
LUIS VELA DO
PHYSICIAN	40.00		764077	0	46675			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4565611	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	755531	TotalReportableCompFrmRltdOrgs
Total Other Compensation	537262	TotalOtherCompensation
Number Individuals GT100 K	240	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
Related Organizations	453330	RelatedOrganizations
Government Grants	22531	GovernmentGrants
Total Contributions	475861	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE	900099	320166306	320166306
RETAIL PHARMACY	446110	6321287	5257233	1064054

Field	Value	IRS element (for citing)
Total Program Service Revenue	326487593	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	483698	TotalRevenueColumn
Exclusion	$483,698	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	723292	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	287484	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	435808	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	435808	TotalRevenueColumn
Exclusion	$435,808	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	850356	Securities
Other	2655	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	685548	Securities
Other	53016	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	164808	Securities
Other	-50361	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	114447	TotalRevenueColumn
Exclusion	$114,447	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	238019	GrossSalesOfInventory
Cost Of Goods Sold	129618	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	108401	TotalRevenueColumn
Related Or Exempt Function Income	108401	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA	722210	1915106	$1,915,106
MISCELLANEOUS REVENUE	900099	187721		49938	137783
RELEASE OF INFORMATION	561000	50654		50654

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	9677	TotalRevenueColumn
Related Or Exempt Function Income	9677	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	2163158	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	330268966	TotalRevenueColumn
Related Or Exempt Function Income	325642209	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1201837	UnrelatedBusinessRevenue
Exclusion	$2,949,059	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	211903	Total
Program Services	211903	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	67384	Total
Program Services	67384	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1145078	Total
Program Services	948412	ProgramServices
Management And General	196666	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	130364560	Total
Program Services	125504874	ProgramServices
Management And General	4769498	ManagementAndGeneral
Fundraising	90188	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	10511946	Total
Program Services	10123497	ProgramServices
Management And General	381240	ManagementAndGeneral
Fundraising	7209	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	23336212	Total
Program Services	22473867	ProgramServices
Management And General	846341	ManagementAndGeneral
Fundraising	16004	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	9053179	Total
Program Services	8718636	ProgramServices
Management And General	328334	ManagementAndGeneral
Fundraising	6209	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	227478	Total
Management And General	227478	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	4275	Total
Management And General	4275	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	5301077	Total
Program Services	5193553	ProgramServices
Management And General	91206	ManagementAndGeneral
Fundraising	16318	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	82114	Total
Program Services	37988	ProgramServices
Management And General	35887	ManagementAndGeneral
Fundraising	8239	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	11117542	Total
Program Services	10663165	ProgramServices
Management And General	378621	ManagementAndGeneral
Fundraising	75756	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	9415564	Total
Management And General	9415564	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3929630	Total
Program Services	3921361	ProgramServices
Management And General	3851	ManagementAndGeneral
Fundraising	4418	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	307093	Total
Program Services	298341	ProgramServices
Management And General	8752	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	1040274	Total
Program Services	944127	ProgramServices
Management And General	89868	ManagementAndGeneral
Fundraising	6279	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	5278916	Total
Program Services	4962625	ProgramServices
Management And General	316291	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	11311928	Total
Program Services	11025636	ProgramServices
Management And General	285586	ManagementAndGeneral
Fundraising	706	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2975299	Total
Program Services	2970607	ProgramServices
Management And General	4692	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
MEDICAL SUPPLIES	52107654	52107654
PURCHASED SERVICES	41648997	12127185	29501380	20432
DUES, TAXES, & LICENSES	10131053	10066253	64214	586

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	329569156	Total
Program Services	282367068	ProgramServices
Management And General	46949744	ManagementAndGeneral
Fundraising	252344	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	9434	BOY
EOY	11479	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2169481	BOY
EOY	2030102	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	38052553	BOY
EOY	39678514	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	101427	BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	441927	BOY
EOY	380498	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	5019356	BOY
EOY	4787976	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2072746	BOY
EOY	2012409	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	229075285	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	111998939	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	119424458	BOY
EOY	117076346	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	12908435	BOY
EOY	12452050	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	407488	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	3373849	BOY
EOY	5441764	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	183573666	BOY
EOY	184278626	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	27279338	BOY
EOY	27472839	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	31037	BOY
EOY	21539	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	3708000	BOY
EOY	3708000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	7872081	BOY
EOY	8549506	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	37909011	BOY
EOY	51160769	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	76799467	BOY
EOY	90912653	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	106774199	BOY
EOY	93365973	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	106774199	BOY
EOY	93365973	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	183573666	BOY
EOY	184278626	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	699810	ReconcilationRevenueExpenses
Reconcilation Other Changes	-14108036	ReconcilationOtherChanges
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	4975845	BeginningOfYearBalance
Contributions	106549	Contributions
Investment Earnings Or Losses	-131912	InvestmentEarningsOrLosses
Grants Or Scholarships	191901	GrantsOrScholarships
End Of Year Balance	4758581	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4582212	BeginningOfYearBalance
Contributions	211952	Contributions
Investment Earnings Or Losses	443652	InvestmentEarningsOrLosses
Grants Or Scholarships	261971	GrantsOrScholarships
End Of Year Balance	4975845	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3963225	BeginningOfYearBalance
Contributions	107306	Contributions
Investment Earnings Or Losses	645769	InvestmentEarningsOrLosses
Grants Or Scholarships	134088	GrantsOrScholarships
End Of Year Balance	4582212	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4989374	BeginningOfYearBalance
Contributions	188135	Contributions
Investment Earnings Or Losses	-1015783	InvestmentEarningsOrLosses
Grants Or Scholarships	198501	GrantsOrScholarships
End Of Year Balance	3963225	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.20930	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.79070	PermanentEndowmentEOYBalance
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	2208871	OtherCostOrOtherBasis
Book Value	2208871	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	140942257	OtherCostOrOtherBasis
Depreciation	58587826	Depreciation
Book Value	82354431	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2810337	OtherCostOrOtherBasis
Depreciation	418054	Depreciation
Book Value	2392283	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	69441132	OtherCostOrOtherBasis
Depreciation	49181254	Depreciation
Book Value	20259878	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	13672688	OtherCostOrOtherBasis
Depreciation	3811805	Depreciation
Book Value	9860883	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	117076346	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescription	AmountAmount
PROFESSIONAL LIABILITY RESERVE	$1,436,000
OTHER LIABILITIES	$367,913
PAYABLE TO CONTRACTUAL AGENCIES	$4,356,273
MINIMUM PENSION LIABILITY	$40,601,911
ACCRUED INTEREST	$1,233,198
TENANTS DEPOSITS	$23,583
ACCOUNTS PAYABLE-AFFILIATES	$3,141,891

Field	Value	IRS element (for citing)
Total Of Amounts	51160769	TotalOfAmounts
Total Revenue	330268966	TotalRevenue
Total Expenses	329569156	TotalExpenses
Excess Or Deficit For Year	699810	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-894525	NetUnrealizedGLOnInvestments
Other	-$13,213,511	OtherAmount
Total Adjustments	-14108036	TotalAdjustments
Excess Or Deficit Per FS	-13408226	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	330327802	TotRevenueEtcAuditedFinclStmt
Other Revenues	308133	OtherRevenues
Revenue Not Rptd F990	308133	RevenueNotRptdF990
Revenue Subtotal	330019669	RevenueSubtotal
Other Revenues Not Included	249297	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	249297	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	330268966	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	329877289	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	308133	OtherExpensesIncluded
Expenses Not Rptd F990	308133	ExpensesNotRptdF990
Expenses Subtotal	329569156	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	329569156	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE GOOD SAMARITAN HOSPITAL FOUNDATION (GSHF) HOLDS ENDOWMENT FUNDS THAT WILL ULTIMATELY BENEFIT THE HOSPITAL. GSHF'S BOARD-DESIGNATED AND GENERAL ENDOWMENTS ARE USED FOR GENERAL HOSPITAL SUPPORT. GSHF'S BERNIER ENDOWMENT IS USED FOR STAFF CONTINUING EDUCATION. GSHF'S ERKKILA ENDOWMENT IS USED FOR HEALTH AND HUMAN PERFORMANCE RESEARCH AND REHABILITATION. GSHF'S MULLINS SCHOLARSHIP ENDOWMENT SUPPORTS EDUCATIONAL SCHOLARSHIPS. GSHF'S PASTEGA HOUSE ENDOWMENT HELPS UNDERWRITE THE OPERATING COSTS OF THE MARIO PASTEGA GUEST HOUSE. GSHF'S VRTISKA ENDOWMENT SUPPORTS THE HOSPITAL'S LABORATORY FOR EDUCATIONAL PURPOSES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:		DISTRIBUTIONS TO MINORITY INTEREST CONSOLIDATED JVS -1,360,146. INCREASE IN MINIMUM PENSION LIABILITY -11,856,043. OTHER CHANGES IN FUND BALANCE 2,678. TOTAL TO SCHEDULE D, PART XI, LINE 8: -13,213,511.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		RENT EXP PER AFS NETTED WITH RENT REV PER TAX RETURN 177,954. RENT REV PER AFS NETTED WITH RENT EXP PER TAX RETURN 130,179.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		CONTRIBUTION REVENUE - CHANGE IN NET ASSETS PER AFS 249,297.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		RENT EXP PER AFS NETTED WITH RENT REV PER TAX RETURN 177,954. RENT REV PER AFS NETTED WITH RENT EXP PER TAX RETURN 130,179.

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
Pcent150	X	Pcent150
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	20	NumberOfActivitiesOrPrograms
Persons Served	8382	PersonsServed
Total Community Benefit Expense	10908664	TotalCommunityBenefitExpense
Net Community Benefit Expense	10908664	NetCommunityBenefitExpense
Percent Of Total Expense	0.03310	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	8	NumberOfActivitiesOrPrograms
Persons Served	55396	PersonsServed
Total Community Benefit Expense	41749170	TotalCommunityBenefitExpense
Direct Offsetting Revenue	37037547	DirectOffsettingRevenue
Net Community Benefit Expense	4711623	NetCommunityBenefitExpense
Percent Of Total Expense	0.01430	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	28	NumberOfActivitiesOrPrograms
Persons Served	63778	PersonsServed
Total Community Benefit Expense	52657834	TotalCommunityBenefitExpense
Direct Offsetting Revenue	37037547	DirectOffsettingRevenue
Net Community Benefit Expense	15620287	NetCommunityBenefitExpense
Percent Of Total Expense	0.04740	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	24	NumberOfActivitiesOrPrograms
Persons Served	5873	PersonsServed
Total Community Benefit Expense	690592	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6034	DirectOffsettingRevenue
Net Community Benefit Expense	684558	NetCommunityBenefitExpense
Percent Of Total Expense	0.00210	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	5	NumberOfActivitiesOrPrograms
Persons Served	4791	PersonsServed
Total Community Benefit Expense	7629498	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3029989	DirectOffsettingRevenue
Net Community Benefit Expense	4599509	NetCommunityBenefitExpense
Percent Of Total Expense	0.01400	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	186489	PersonsServed
Total Community Benefit Expense	73637280	TotalCommunityBenefitExpense
Direct Offsetting Revenue	35175333	DirectOffsettingRevenue
Net Community Benefit Expense	38461947	NetCommunityBenefitExpense
Percent Of Total Expense	0.11670	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	17	NumberOfActivitiesOrPrograms
Persons Served	4367	PersonsServed
Total Community Benefit Expense	781753	TotalCommunityBenefitExpense
Direct Offsetting Revenue	177954	DirectOffsettingRevenue
Net Community Benefit Expense	603799	NetCommunityBenefitExpense
Percent Of Total Expense	0.00180	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	72	NumberOfActivitiesOrPrograms
Persons Served	201520	PersonsServed
Total Community Benefit Expense	82739123	TotalCommunityBenefitExpense
Direct Offsetting Revenue	38389310	DirectOffsettingRevenue
Net Community Benefit Expense	44349813	NetCommunityBenefitExpense
Percent Of Total Expense	0.13460	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	100	NumberOfActivitiesOrPrograms
Persons Served	265298	PersonsServed
Total Community Benefit Expense	135396957	TotalCommunityBenefitExpense
Direct Offsetting Revenue	75426857	DirectOffsettingRevenue
Net Community Benefit Expense	59970100	NetCommunityBenefitExpense
Percent Of Total Expense	0.18200	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	838	PersonsServed
Total Community Building Expense	5905	TotalCommunityBuildingExpense
Net Community Building Expense	5905	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	58	PersonsServed
Total Community Building Expense	1819	TotalCommunityBuildingExpense
Net Community Building Expense	1819	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	896	PersonsServed
Total Community Building Expense	7724	TotalCommunityBuildingExpense
Net Community Building Expense	7724	NetCommunityBuildingExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$4,972,196	BadDebtExpenseAmount
Amount Attributable To	265719	AmountAttributableTo
Amount Reimbursed By Medicare	43698995	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	49515854	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-5816859	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
1 CORVALLIS MED BLDGS LLC
REAL PROPERTY RENTAL	0.54500	0.18500
2 HULL IMAGING LLC
IMAGING SERVICES	0.60000	0.40000
3 SAMARITAN ENDOSCOPY CENTER
MEDICAL SERVICES	0.66670	0.33330
4 CORVALLIS MRI A JV
IMAGING SERVICES	0.50000	0.50000
5 CASCADE VIEW MEDICAL OFFICE BUILDING LLC
REAL PROPERTY RENTAL	0.34000	0.31450

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	GOOD SAMARITAN HOSPITAL CORVALLIS	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	3600 NW SAMARITAN DRIVE	AddressLine1
City	CORVALLIS	City
State	OR	State
ZIP Code	97330	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Teaching Hospital	X	TeachingHospital
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	GOOD SAMARITAN HOSPITAL CORVALLIS	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	150.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	200.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	28	NumberOfOtherFacilities

Other Facilities OtherFacilities (28 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
SAMARITAN REGIONAL CANCER CENTER
501 NW ELKS DR	CORVALLIS	OR	97330	RADIATION ONCOLOGY
SAMARITAN ORTHOPEDICS CLINIC
3620 NW SAMARITAN DR STE 202	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN HEART & VASC - VASC SURGERY
3615 NW SAMARITAN DR STE 201	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN SURGICAL SPECIALISTS
3615 NW SAMARITAN DR STE 201	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN GYN & SURGICAL ASSOCIATES
400 NW WALNUT BLVD STE 300	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN INTERNAL MEDICINE
3615 NW SAMARITAN DR STE 100	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN NEUROSURGERY - DR ROBERSON
3615 NW SAMARITAN DR STE 210	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN NEUROSURGERY - DR GOODWIN
3615 NW SAMARITAN DR STE 211	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN FAMILY MEDICINE
3517 NW SAMARITAN DR STE 201	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
MAMMOGRAPHY CLINIC
444 NW ELKS DR	CORVALLIS	OR	97330	MAMMOGRAPHY CLINIC
SAMARITAN KIDNEY SPECIALISTS
3615 NW SAMARITAN DR STE 203	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN PEDIATRICS
3517 NW SAMARITAN DR STE C	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN URGENT CARE CENTER
5234 SW PHILOMATH BLVD	CORVALLIS	OR	97333	MEDICAL CLINIC - OUTPATIENT
SAMARITAN DERMATOLOGY
2358 NW KINGS BLVD STE 100	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN ENDOSCOPY CENTER
3509 NW SAMARITAN DR STE 201	CORVALLIS	OR	97330	ENDOSCOPY CENTER
CORVALLIS MRI
3615 NW SAMARITAN DR STE 101	CORVALLIS	OR	97330	IMAGING SERVICS
CORVALLIS HEARTSPRING WELLNESS CENTER
990 NW CIRCLE BLVD STE 201	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN OBSTETRICS & GYN
3640 NW SAMARITAN DR STE 270	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN MENTAL HEALTH - CORVALLIS
3509 NW SAMARITAN DR	CORVALLIS	OR	97330	MENTAL HEALTH SERVICES
SAMARITAN PLASTICRECON SURG - HAVARD
996 NW CIRCLE BLVD STE 103	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN HEMATOLOGY & ONCOLOGY
3640 NW SAMARITAN DR STE 161	CORVALLIS	OR	97330	RADIATION ONCOLOGY
SAMARITAN ORTHOPEDICS - DR VELA
3620 NW SAMARITAN DR STE 201	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN MENTAL HEALTH - ALBANY
1052 SW 29TH ST	ALBANY	OR	97321	MENTAL HEALTH SERVICES
SAMARITAN INFECTIOUS DISEASE
3640 NW SAMARITAN DR STE 210	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN UROLOGY
990 NW CIRCLE BLVD STE 102	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN RHEUMATOLOGY
2358 NW KINGS BLVD STE 100	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
SAMARITAN HAND THERAPY
3640 NW SAMARITAN DR	CORVALLIS	OR	97330	MEDICAL CLINIC - OUTPATIENT
OUTPATIENT SURGERY
3620 NW SAMARITAN DR	CORVALLIS	OR	97330	AMBULATORY SURGERY

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 6A: THE FILING ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT TO THE STATE OF OREGON. IN ADDITION, THE PARENT ORGANIZATION, SAMARITAN HEALTH SERVICES (SHS) PROVIDES AN ANNUAL REPORT TO THE COMMUNITY THAT INCLUDES COMMUNITY BENEFIT REPORTING FOR THE SYSTEM AS A WHOLE.
PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN SCHEDULE H, PART I, LINE 7A AND 7B IS A COST-TO-CHARGE RATIO DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES FROM THE SCHEDULE H INSTRUCTIONS. FOR LINE 7G, A COMBINATION OF THE COST-TO-CHARGE RATIO AND COST ACCOUNTING SYSTEM CALCULATIONS IS USED SINCE NOT ALL SERVICES ARE TRACKED IN THE COST ACCOUNTING SYSTEM.
PART I, LINE 7G: PHYSICIAN CLINICS MEETING THE DEFINITION OF SUBSIDIZED HEALTH SERVICES WERE INCLUDED IN THE REPORTING FOR LINE 7G. THE PORTION OF NET COMMUNITY BENEFIT EXPENSE RELATED TO THESE CLINICS IS $31,346,209.
PART II: GSH PROVIDES SERVICES AND ACTIVITIES THAT ARE CLASSIFIED AS COMMUNITY BUILDING. THIS INCLUDES LEADING DISASTER PREPAREDNESS DRILLS WITH LOCAL AGENCIES AND STAFF PARTICIPATING IN ONE-ON-ONE MENTORING PROGRAMS AT A LOCAL SCHOOL. GSH ALSO PROVIDES OPPORTUNITIES FOR COMMUNITY MEMBERS TO OBTAIN TRAINING ON CIVIC AND CULTURAL ISSUES THAT IMPACT HEALTH. SOME OF THE TRAINING OPPORTUNITIES INCLUDED GRANT WRITING AND BOARD DEVELOPMENT. GSH STAFF SERVE ON MANY LOCAL COALITIONS AND BOARDS THAT PROMOTE THE HEALTH OF THE COMMUNITY. BOARD AFFILIATION INCLUDES, BUT IS NOT LIMITED TO COMMUNITY OUTREACH INC, THE GRACE CENTER, THE CENTER FOR HEALTHY AGING RESEARCH/SCIENTIFIC ADVISORY BOARD, AND THE CARING PLACE. ADDITIONALLY GSH STAFF SERVE ON THE OREGON HEALTH POLICY ADVISORY BOARD, THE OREGON HEALTH RESOURCES COMMISSION, THE MEDICAID ADVISORY COMMITTEE AND REGIONAL BOARDS THAT ADDRESS HEALTH CARE ISSUES.
PART III, LINE 4: THE COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE (AT COST) ON LINE 2 OF PART III IS BASED ON THE FACILITY COST-TO-CHARGE RATIO, IN CONJUNCTION WITH WORKSHEET A FROM THE SCHEDULE H, PART III INSTRUCTIONS.LINE 3 REPRESENTS AN ESTIMATE OF THE AMOUNT OF COST INCLUDED IN LINE 2 (BAD DEBT EXPENSE AT COST) THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, BUT FOR WHOM THE ORGANIZATION WAS NOT ABLE TO OBTAIN SUFFICIENT INFORMATION TO MAKE A DETERMINATION. THE METHODOLOGY USED TO ESTIMATE THIS POTENTIAL CHARITY CARE COST IS BASED ON FINANCIAL ASSISTANCE APPLICATIONS DENIED DUE TO INCOMPLETE DOCUMENTATION, MULTIPLIED BY THE AVERAGE CHARITY CARE WRITE-OFF FOR APPROVED APPLICATIONS.GOOD SAMARITAN HOSPITAL (GSH) IS THE LARGEST OF FIVE HOSPITALS OF SAMARITAN HEALTH SERVICES (SHS). AS A NETWORK, SHS PREPARES ITS FINANCIAL STATEMENTS ON A CONSOLIDATED BASIS. FOOTNOTE 1(O) FROM THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ENTITLED "PROVISION FOR BAD DEBTS AND ALLOWANCE FOR DOUBTFUL ACCOUNTS" DESCRIBES BAD DEBT EXPENSE AS FOLLOWS: "ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, SHS ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE PATIENTS WITHOUT INSURANCE), SHS RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. FOR THIRD-PARTY RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, SHS ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, WHICH PRIMARILY RELATES TO SELF-PAY PATIENT BALANCES THAT WILL REMAIN AFTER PAYMENTS FROM THE THIRD-PARTY PAYOR HAVE BEEN COLLECTED. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS."
PART III, LINE 8: TOTAL MEDICARE ALLOWABLE COSTS REPORTED ON PART III, SECTION B, LINE 6 IS CALCULATED BY UTILIZING WORKSHEET B IN THE SCHEDULE H INSTRUCTIONS IN CONJUNCTION WITH AMOUNTS TAKEN DIRECTLY FROM THE FILING ORGANIZATION'S MEDICARE COST REPORT (CALCULATED BASED ON A COST-TO-CHARGE RATIO). CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED, AS THESE PATIENTS TYPICALLY HAVE LOW OR FIXED INCOMES AND GOVERNMENT REIMBURSEMENT IS NOT SUFFICIENT TO COVER THE COSTS OF PROVIDING CARE FOR THESE PATIENTS. MEDICARE PATIENTS ARE A GROWING SEGMENT OF THE LOCAL POPULATION, AND MANY ARE BECOMING INCREASINGLY DEPENDENT ON OUR HOSPITAL AND NON-PROFIT AFFILIATES TO PROVIDE FOR THEIR CARE, ESPECIALLY AS OTHER FOR-PROFIT HEALTHCARE PROVIDERS IN THE COMMUNITY DISCONTINUE ACCEPTING MEDICARE PATIENTS.THE AMOUNT OF MEDICARE SHORTFALL SHOWN ON LINE 7 OF PART III, SECTION B, IS UNDERSTATED. THIS IS PRIMARILY DUE TO THE FACT THAT THE MEDICARE COST REPORT INCLUDES ACTIVITY FOR MEDICARE FEE-FOR-SERVICE PATIENTS BUT NOT MEDICARE MANAGED CARE PATIENTS. MEDICARE MANAGED CARE ACCOUNTS FOR ROUGHLY HALF OF OUR MEDICARE ACTIVITY. IN ADDITION, CERTAIN COSTS OF PROVIDING HEALTHCARE SERVICES, SUCH AS PHYSICIAN COMPENSATION, ARE NOT ALLOWABLE ON THE MEDICARE COST REPORTS. THEREFORE, THE AMOUNT OF MEDICARE SHORTFALL SHOWN ON LINE 7 IS SMALLER THAN THE SHORTFALL CALCULATION USING REVENUE AND COST DATA FOR ALL MEDICARE PATIENT ACTIVITY, AS FOLLOWS:NET REV RECEIVED FROM MEDICARE (ALL MEDICARE PATIENT PROGRAMS):83,236,002MEDICARE COSTS (BASED ON A COST-TO-CHARGE RATIO): 100,898,872UNPAID COST OF PROVIDING SERVICES TO ALL MEDICARE PATIENTS: (17,662,870)
PART III, LINE 9B: PER HOSPITAL GUIDELINES, IF A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE PRIOR TO SENDING AN ACCOUNT TO COLLECTIONS, THE CHARITY WRITE-OFF IS PROCESSED AND NO COLLECTION ATTEMPT IS MADE. IF AN ACCOUNT IS ALREADY IN COLLECTIONS AND MEDICAID ELIGIBILITY IS DEEMED ACTIVE DURING THE ACCOUNT DATE OF SERVICE, NO FURTHER COLLECTION ATTEMPT WILL BE MADE.
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED BY THE HOSPITAL FACILITY TO FAP-ELIGIBLE INDIVIDUALS IS SET TO BE LESS THAN THE AVERAGE OF ALL NEGOTIATED COMMERCIAL INSURANCE RATES.	GOOD SAMARITAN HOSPITAL, CORVALLIS
PART VI, LINE 2: GOOD SAMARITAN HOSPITAL (GSH) ACTIVELY PARTICIPATES IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY. IN CONJUNCTION WITH THE UNITED WAY OF BENTON COUNTY, THE CITY OF CORVALLIS, BENTON COUNTY HEALTH DEPARTMENT, BENTON COUNTY FEDERALLY QUALIFIED HEALTH CENTER, OREGON STATE UNIVERSITY, THE BENTON COUNTY COMMISSION ON CHILDREN AND FAMILIES AND OTHER COMMUNITY PARTNERS, GSH EMPLOYEES AND OTHER SAMARITAN HEALTH SERVICES STAFF ACTIVELY PARTICIPATED IN A COMMUNITY NEEDS ASSESSMENT DURING 2010. THIS PROCESS INCLUDED EXAMINING PRIMARY DATA COLLECTED THROUGH FOCUS GROUPS, COMMUNITY FORUMS AND PERSONAL INTERVIEWS WITH SEVERAL COMMUNITY MEMBERS FROM THROUGHOUT BENTON COUNTY. SECONDARY DATA WAS GATHERED FROM STATE AND LOCAL AGENCIES THAT ADDRESS HEALTH NEEDS OF CHILDREN, YOUTH AND FAMILIES. AS A RESULT OF THE COMMUNITY NEEDS ASSESSMENT, GSH IS ABLE TO UPDATE THE ANNUAL COMMUNITY BENEFIT PLAN THAT OUTLINES GOALS, OBJECTIVES AND SERVICES THAT EXPAND ACROSS THE SAMARITAN HEALTH SERVICES SYSTEM RESPONDING TO COMMUNITY NEEDS.
PART VI, LINE 3: GSH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTH CARE SERVICES TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. IF QUALIFICATIONS ARE MET, PATIENTS' CARE MAY BE PROVIDED FREE OR AT A REDUCED COST. THE DETERMINATION IS BASED IN PART ON POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. ONCE A COMPLETED FINANCIAL QUESTIONNAIRE HAS BEEN SUBMITTED, INDIVIDUALS/FAMILIES AT OR BELOW 200 PERCENT OF THE ESTABLISHED FEDERAL POVERTY LEVEL (FPL) COULD BE ELIGIBLE TO RECEIVE FREE OR DISCOUNTED CARE (CHARITY CARE).THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND COMMUNITY MEMBERS BY PUBLISHING INFORMATION REGARDING ALL FINANCIAL ASSISTANCE OPTIONS ON ITS WEBSITE, IN ADDITION TO IN PERSON AT THE REGISTRATION AREA, AND THROUGH CLEARLY IDENTIFIED MATERIALS LOCATED IN THE REGISTRATION AREA.
PART VI, LINE 4: GSH PRIMARILY SERVES THE RESIDENTS OF BENTON COUNTY. HOWEVER, RESIDENTS FROM THE ADJOINING COMMUNITIES OF LINCOLN AND LINN COUNTIES ARE ALSO SEEN AT GSH. WITH A TOTAL POPULATION OF 85,579 (U.S. CENSUS 2010), BENTON COUNTY IS DESIGNATED AS AN URBAN COUNTY. THE COUNTY INCLUDES THE CITIES OF CORVALLIS AND PHILOMATH AS WELL AS THE SMALL INCORPORATED TOWNSHIPS OF MONROE AND ADAIR VILLAGE. APPROXIMATELY 21% OF BENTON COUNTY RESIDENTS LIVE IN RURAL AREAS OF THE COUNTY. THE MEDIAN HOUSEHOLD INCOME FOR BENTON COUNTY IS $71,800, AND 16.1% OF THE RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL. AS OF DECEMBER 2011, THE OREGON EMPLOYMENT DEPARTMENT REPORTED A 5.9% UNEMPLOYMENT RATE FOR BENTON COUNTY. ACCORDING TO THE 2012 COUNTY HEALTH RANKINGS, 17% OF BENTON COUNTY RESIDENTS ARE UNINSURED. PORTIONS OF BENTON COUNTY HAVE DESIGNATIONS OF MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ACCORDING TO THE HEALTH RESOURCES AND SERVICES ADMINISTRATION, WITH GSH BEING THE ONLY HOSPITAL LOCATED IN BENTON COUNTY.
PART VI, LINE 5: GSH'S GOVERNING BOARD IS COMPRISED OF LOCAL-AREA RESIDENTS. THE MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT, MEANING THEY AND THEIR FAMILY MEMBERS ARE NOT EMPLOYEES OF GSH NOR DO THEY HAVE ANY SIGNIFICANT BUSINESS RELATIONSHIPS WITH GSH. GSH EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. GSH APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. GSH INVESTS IN UPDATING EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. GSH IS ACCREDITED FOR CONTINUING MEDICAL EDUCATION AND OFFERS WEEKLY PROGRAMS FOR AREA PHYSICIANS AND OTHER HEALTH PROFESSIONALS. THE CENTER FOR HEALTH RESEARCH AND QUALITY, A DEPARTMENT OF GSH'S PARENT COMPANY, SAMARITAN HEALTH SERVICES (SHS), PROVIDES ADMINISTRATIVE OVERSIGHT FOR HEALTH AND CLINICAL RESEARCH, QUALITY IMPROVEMENT PROJECTS AND STUDIES, AND OTHER SPONSORED ACTIVITIES FOR GSH AND ITS AFFILIATED HOSPITALS. GSH ALSO CONTRIBUTES FINANCIALLY TO THE LINN-BENTON COMMUNITY COLLEGE NURSING PROGRAM.
PART VI, LINE 6: "BUILDING HEALTHIER COMMUNITIES TOGETHER" IS THE COMMITMENT OF, AND THE MOTIVATION FOR, SAMARITAN HEALTH SERVICES (SHS), A NETWORK OF OREGON HOSPITALS, PHYSICIANS, AND SENIOR CARE FACILITIES THAT SERVES THE HEALTH CARE NEEDS OF PEOPLE IN THE MID-WILLAMETTE VALLEY AND THE CENTRAL OREGON COAST.AS THE INDIVIDUAL ENTITIES OF SHS CAME TOGETHER TO BUILD HEALTHIER COMMUNITIES, THEY WERE DRAWN BY A SHARED MISSION "TO ENHANCE COMMUNITY HEALTH AND ACHIEVE HIGH VALUE THROUGH QUALITY SERVICES ACROSS THE CONTINUUM OF CARE." THAT MEANS SHS LOOKS CAREFULLY AT LOCAL HEALTH CARE NEEDS, AND IT GIVES THOUGHTFUL CONSIDERATION TO THE MOST EFFECTIVE WAYS TO MEET THOSE NEEDS. THE RESULT IS A RICH MIX OF LOCAL AND CENTRALIZED REGIONAL SERVICES WHICH PROVIDE HIGH VALUE AND EXCELLENT HEALTHCARE FOR PEOPLE AT ALL STAGES OF THEIR LIVES. SERVICES ARE PROVIDED TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY. THE COLLECTIVE VISION OF SHS IS TO SUCCESSFULLY OPERATE AS A VALUES-DRIVEN, CHURCH-RELATED ORGANIZATION GOVERNED BY A PARTNERSHIP OF COMMUNITY MEMBERS, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. SHS SEEKS TO LEAD COLLABORATIVE EFFORTS AMONG PROVIDERS, EMPLOYERS, HEALTH PLANS AND CONSUMERS WHO SHARE SIMILAR GOALS AND VALUES TO MEET THE CHALLENGES OF THE FUTURE.GSH IS THE FLAGSHIP HOSPITAL OF SHS. IT PRIMARILY SERVES RESIDENTS OF BENTON COUNTY. OTHER AFFILIATED HOSPITALS ARE SAMARITAN ALBANY GENERAL HOSPITAL AND SAMARITAN LEBANON COMMUNITY HOSPITAL, SERVING RESIDENTS OF LINN COUNTY, AND SAMARITAN NORTH LINCOLN HOSPITAL AND SAMARITAN PACIFIC COMMUNITIES HOSPITAL, SERVING RESIDENTS OF LINCOLN COUNTY.
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 (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
COMMUNITY OUTREACH
865 REIMAN AVENUE	CORVALLIS	OR	97330	930602094	501(C)(3)	77148	MEDICAL, DENTAL, MENTAL HEALTH CLINICS
OLD MILL CENTER
1650 SW 45TH PLACE	CORVALLIS	OR	97333	930722603	501(C)(3)	43750	SUPPORT FOR HIGH RISK INFANTS
ALBANY HELPING HANDS
PO BOX 2252	ALBANY	OR	97321	931244271	501(C)(3)	7150	SUPPORT FOR HOMELESS PEOPLE
CENTER AGAINST RAPE & DOMESTIC VIOLENCE
PO BOX 914	CORVALLIS	OR	97339	930792125	501(C)(3)	35000	TRANSITIONAL HOUSING SERVICES FOR DOMESTIC VIOLENCE SURVIVORS
DIAL A BUS
605 NW 27TH STREET	CORVALLIS	OR	97330	264836268	501(C)(3)	5800	TRANSPORTATION SUBSIDIES FOR NEEDY PATIENTS
ALSEA RURAL HEALTH CARE INC
PO BOX 229	ALSEA	OR	97324	930773246	501(C)(3)	15000	RURAL HEALTHCARE SUPPORT
BENTON COUNTY HEALTH DEPARTMENT
530 NW 27TH ST	CORVALLIS	OR	97330	936002285	GOV'T	11040	ORAL HEALTH SUPPORT
CORVALLIS DAYTIME DROP-IN CENTER
316 SW WASHINGTON AVE STE 410	CORVALLIS	OR	97330	800019915	501(C)(3)	9100	SUPPORT FOR THE COMMUNICABLE DISEASE PREVENTION PROJECT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	8	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (5 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance
TRANSPORTATION	506	24627
MEDICAL ASSISTANCE	8		283	BOOK	MEDICAL SUPPLIES
SHELTER	21	576
MEALS FOR FAMILY MEMBERS OF PATIENTS	626		6261	BOOK	MEALS
ACCOMODATIONS - PASTEGA HOUSE	6493		35637	BOOK	TEMPORARY HOUSING FOR HEALTH CARE RECIPIENTS

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: AGENCIES IN THE COMMUNITY ARE INVITED TO SUBMIT GRANT PROPOSALS THROUGH AN APPLICATION PROCESS. A COMMITTEE REVIEWS THE APPLICATIONS TO DETERMINE IF THE FUNDS REQUESTED WILL BE USED TO ADDRESS THE ORGANIZATION'S ESTABLISHED COMMUNITY HEALTH PRIORITIES, IDENTIFIED NEEDS, AND SUPPORTS THE ORGANIZATION'S MISSION. ONCE APPROVED AND FUNDED, AGENCIES MUST SUBMIT A COMPLETE ANNUAL REPORT DESCRIBING HOW THE FUNDS WERE USED, THE NUMBER OF CLIENTS SERVED, AND HOW OUTCOMES WERE ACHIEVED.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	1	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 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
FREDERICK WEISENSEE MD
288599	0	2632	0	15082	0	23736	0	15457	0	345506	0	0	0
STEVEN W JASPERSON
0	375305	0	29000	0	30618	0	38497	0	26869	0	500289	0	0
DANIEL B SMITH
0	285276	0	28000	0	7332	0	20228	0	31203	0	372039	0	0
KATHRYN M HALE
163469	0	9665	0	2814	0	25290	0	19328	0	220566	0	0	0
MICHAEL A MAY MD
280513	0	10600	0	5236	0	36172	0	31210	0	363731	0	0	0
SCOTT WILSON
140093	0	7440	0	12534	0	11929	0	24669	0	196665	0	0	0
STEVEN GOODWIN MD
625653	0	6000	0	1283	0	20228	0	23802	0	676966	0	0	0
DONALD PENNINGTON DO
846558	0	5500	0	810	0	20228	0	31414	0	904510	0	0	0
TOSHIO NAGAMOTO MD
725968	0	3500	0	17310	0	20228	0	28930	0	795936	0	0	0
RANDALL V BREAM MD
590223	0	4800	0	16642	0	20228	0	20941	0	652834	0	0	0
LUIS VELA DO
748467	0	14800	0	810	0	20228	0	26447	0	810752	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference

ExplanationExplanation

PART I, LINE 1A

IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM REIMBURSEMENT BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. THE EMPLOYEE MUST ATTEND THE GYM FOR 6 CONSECUTIVE MONTHS, AT LEAST 50 TIMES, IN ORDER TO QUALIFY FOR REIMBURSEMENT. THIS GYM REIMBURSEMENT BENEFIT IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES AND IS SUBJECT TO STATE/FEDERAL WITHHOLDING TAX. ONE OFFICER AND TWO KEY EMPLOYEES RECEIVED THIS BENEFIT IN 2011.

PART I, LINE 5

VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	TANIA MAY	BusinessNameLine1

Field	Value	IRS element (for citing)
Relationship	FAM MBR, M. MAY	Relationship
Amount Of Transaction	117886	AmountOfTransaction
Description Of Transaction	EMP BY ORG	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 4	SECTION 7.1.5 OF THE ORGANIZATION'S BYLAWS WERE AMENDED WHEREBY THE BOARD DEVELOPMENT COMMITTEE IS TO BE RESPONSIBLE FOR REVIEWING THE PERFORMANCE OF THE DIRECTORS. ALSO, THE RESTRICTION NOT ALLOWING BOARD DEVELOPMENT COMMITTEE MEMBERS TO ALSO SERVE AS OFFICERS OF THE BOARD WAS REMOVED.
FORM 990, PART VI, SECTION A, LINE 6	GOOD SAMARITAN HOSPITAL CORVALLIS HAS A SOLE CORPORATE MEMBER, SAMARITAN HEALTH SERVICES, INC., WHICH IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	GOOD SAMARITAN HOSPITAL CORVALLIS ELECTS MEMBERS OF ITS BOARD OF DIRECTORS. THOSE ELECTED MEMBERS ARE THEN SUBMITTED TO THE SOLE CORPORATE MEMBER FOR APPROVAL.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE CORPORATE MEMBER HAS SEVERAL RESERVED POWERS OVER THE ORGANIZATION. THESE RESERVED POWERS INCLUDE, BUT ARE NOT LIMITED TO, APPROVAL AT CERTAIN THRESHOLD LEVELS: THE BORROWING OF FUNDS, MERGERS AND ACQUISITIONS, AND SALES OR TRANSFERS OF ASSETS. IN ADDITION, THE SOLE CORPORATE MEMBER MUST APPROVE ANY CHANGE IN THE MISSION OF THE ORGANIZATION, THE ANNUAL BUDGET, AND ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11	A COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF THE SAMARITAN HEALTH SERVICES (SHS) AUDIT AND COMPLIANCE COMMITTEE PRIOR TO ITS FILING WITH THE IRS. SHS IS A 501(C)(3) CORPORATION AND IS THE SOLE MEMBER OF THE FILING ORGANIZATION. SHS'S CHIEF FINANCIAL OFFICER CONDUCTED THE FORM 990 REVIEW WITH THE COMMITTEE AND PROVIDED TIME FOR QUESTIONS FROM THE GROUP. A FORMAL REPORT OF THIS COMMITTEE HAS BEEN MADE TO THE FULL BOARD OF DIRECTORS OF SHS.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBER CONFLICTS OF INTEREST: THE MEMBERS OF THE BOARD MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CORPORATE COMPLIANCE OFFICER. IF A CONFLICT IS DISCLOSED THAT COULD PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THIS IS EVALUATED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES (SHS) BOARD OF DIRECTORS TO DETERMINE WHETHER THE MEMBER SHOULD CONTINUE TO SERVE ON THE BOARD. IF A CONFLICT IS DISCLOSED THAT DOES NOT PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THE CONFLICT IS MANAGED THROUGH A PROCESS SET FORTH IN THE ORGANIZATION'S BYLAWS. THE BYLAWS PROHIBIT ANY BOARD MEMBER FROM VOTING ON AN ACTION WHERE AN INDIVIDUAL MEMBER HAS A CONFLICT OF INTEREST. EMPLOYEE CONFLICTS OF INTEREST: THE SHS CODE OF ETHICS AND CONDUCT POLICY REQUIRES THAT ALL SHS EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST. THROUGH THE HUMAN RESOURCES SOFTWARE, PERFORMANCE MANAGER, THE DISCLOSURE REQUIREMENT NOTICE IS ASSIGNED TO ALL EMPLOYEES AND BY YEAR END ALL TASKS ARE TO BE COMPLETED. IF THERE IS A PERCEIVED CONFLICT OF INTEREST IT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, LEGAL COUNSEL AND/OR SENIOR MANAGEMENT. ACTUAL CONFLICTS OF INTEREST ARE REVIEWED AND DISCUSSED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. SYSTEM-WIDE SUMMARIZED DATA IS ALSO PROVIDED IN THE ANNUAL REPORT TO THE COMMUNITY. THIS REPORT IS MADE AVAILABLE IN ALL KIOSKS AND HIGH-TRAFFIC AREAS OF ALL HOSPITALS AND PHYSICIAN CLINICS, AS WELL AS COMMUNITY PLACES SUCH AS THE PUBLIC LIBRARY. IT IS ALSO DISTRIBUTED TO THE BOARDS OF DIRECTORS AND DIRECTLY MAILED TO DONORS AND NEW RESIDENTS IN THE COMMUNITY. ADDITIONALLY, THE REPORT IS MADE AVAILABLE AT ALL EVENTS, COMMUNITY OUTREACH PROJECTS, AND SCREENINGS ATTENDED THROUGHOUT THE YEAR. GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII - COMPENSATION EXPLANATION	MR. JASPERSON'S COMPENSATION WAS PAID BY A RELATED ORGANIZATION FOR WORK DONE FOR THE FILING ORGANIZATION.	STEVEN W. JASPERSON
FORM 990, PART VII - COMPENSATION EXPLANATION	MR. SMITH WORKED 40 HOURS PER WEEK FOR SEVERAL RELATED ORGANIZATIONS. HIS COMPENSATION WAS PAID BY A RELATED ORGANIZATION FOR WORK DONE FOR THE FILING ORGANIZATION AND SEVERAL RELATED ORGANIZATIONS.	DANIEL B. SMITH
FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -894,525. DISTRIBUTIONS TO MINORITY INTEREST CONSOLIDATED JVS -1,360,146. INCREASE IN MINIMUM PENSION LIABILITY -11,856,043. OTHER CHANGES IN FUND BALANCE 2,678. TOTAL TO FORM 990, PART XI, LINE 5: -14,108,036.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (14 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
ALBANY GENERAL HOSPITAL
PO BOX 3000	CORVALLIS	OR	973393000	930110095	HOSPITAL SERVICES FOR THE COMMUNITY	OR	501(C)(3)	3	SAMARITAN HEALTH SERVICES	0
ALBANY GENERAL HOSPITAL FOUNDATION
1046 SIXTH AVENUE SW	ALBANY	OR	97321	930712890	TO SUPPORT ALBANY GENERAL HOSPITAL	OR	501(C)(3)	7	ALBANY GENERAL HOSPITAL	0
FIRSTCARE HEALTH FOUNDATION
PO BOX 3000	CORVALLIS	OR	973393000	930900124	TO SUPPORT AFFILIATED EXEMPT ENTITIES	OR	501(C)(3)	11B, II	SAMARITAN HEALTH SERVICES	0
FIRSTCARE MEDICAL FOUNDATION
PO BOX 3000	CORVALLIS	OR	973393000	930932697	PROVIDER OF MEDICAL SERVICES FOR THE COMMUNITY	OR	501(C)(3)	9	SAMARITAN HEALTH SERVICES	0
GOOD SAMARITAN HOSPITAL AUXILIARY
3600 NW SAMARITAN DRIVE	CORVALLIS	OR	973393000	936024034	TO SUPPORT GOOD SAMARITAN HOSPITAL	OR	501(C)(3)	11D, III-O		1	N/A
GOOD SAMARITAN HOSPITAL FOUNDATION
PO BOX 1068	CORVALLIS	OR	97339	237252406	TO SUPPORT GOOD SAMARITAN HOSPITAL	OR	501(C)(3)	7	GOOD SAMARITAN HOSPITAL	1
INTERCOMMUNITY HEALTH PLANS INC
PO BOX 3000	CORVALLIS	OR	973393000	931124326	SERVE OREGON HEALTH PLAN FOR MEDICAID	OR	501(C)(4)	N/A	SAMARITAN HEALTH SERVICES	0
LEBANON COMMUNITY HOSPITAL FOUNDATION
PO BOX 739	LEBANON	OR	97355	931260080	TO SUPPORT LEBANON COMMUNITY HOSPITAL	OR	501(C)(3)	7	MID-VALLEY HEALTHCARE INC	0
MID-VALLEY HEALTHCARE INC
PO BOX 3000	CORVALLIS	OR	973393000	930396847	HOSPITAL SERVICES FOR THE COMMUNITY	OR	501(C)(3)	3	SAMARITAN HEALTH SERVICES	0
PARADIGM INDEMNITY CORPORATION
PO BOX 3000	CORVALLIS	OR	973393000	731668317	PURE NON-PROFIT CAPTIVE INSURANCE COMPANY	HI	501(C)(3)	11A, I	SAMARITAN HEALTH SERVICES	0
SAMARITAN HEALTH SERVICES INC
PO BOX 3000	CORVALLIS	OR	973393000	930951989	PROVIDE HEALTHCARE SUPPORT SERVICES	OR	501(C)(3)	11C, III-FI		0	N/A
SAMARITAN NORTH LINCOLN HOSPITAL
3043 NE 28TH STREET	LINCOLN CITY	OR	97367	931305493	HOSPITAL SERVICES FOR THE COMMUNITY	OR	501(C)(3)	3	SAMARITAN HEALTH SERVICES	0
SAMARITAN PACIFIC HEALTH SERVICES
930 SW ABBEY STREET	NEWPORT	OR	97365	931329784	HOSPITAL SERVICES FOR THE COMMUNITY	OR	501(C)(3)	3	SAMARITAN HEALTH SERVICES	0
SAMARITAN SENIOR CARE INC
PO BOX 3000	CORVALLIS	OR	973393000	931245534	PROVIDE HEALTHCARE FOR SENIORS	OR	501(C)(3)	9	SAMARITAN HEALTH SERVICES	0

Form990 Schedule R Part III Form990ScheduleRPartIII (11 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	Direct Controlling Entity NADirectControllingEntityNA
SAMARITAN ENDOSCOPY CENTER LLC
3600 NW SAMARITAN DR	CORVALLIS	OR	97330	202860067	MEDICAL SERVICES	OR	GOOD SAMARITAN HOSPITAL	RELATED	478423	781103	0	1	0.66660
CORVALLIS MEDICAL BUILDINGS LLC
3600 NW SAMARITAN DRIVE	CORVALLIS	OH	97330	931257913	REAL ESTATE RENTAL	OR	GOOD SAMARITAN HOSPITAL	EXCLUDED	139168	1471777	0	1	0.54500
EAST LINN MRI LLC
3600 NW SAMARITAN DRIVE	CORVALLIS	OR	97330	320229399	IMAGING	OR	MID-VALLEY HEALTHCARE INC	N/A			0	0
HULL IMAGING LLC
3600 NW SAMARITAN DRIVE	CORVALLIS	OR	97330	203255479	IMAGING	OR	GOOD SAMARITAN HOSPITAL	RELATED	744862	155129	0	1	0.60000
CBA-SAM LLC
PO BOX 433	LINCOLN CITY	OR	97367	931314523	REAL ESTATE RENTAL	OR		N/A			0	0		N/A
CORVALLIS MRI A JOINT VENTURE
3615 NW SAMARITAN DRIVE	CORVALLIS	OR	97330	930949704	IMAGING	OR	GOOD SAMARITAN HOSPITAL	RELATED	456705	459736	0	1	0.50000
MID-VALLEY MEDICAL PROPERTIES ASSOC LLC
1046 SIXTH AVE SW	ALBANY	OR	97321	300508747	REAL ESTATE RENTAL	OR	ALBANY GENERAL HOSPITAL	N/A			0	0
MID-VALLEY MEDICAL BUILDINGS LLC
PO BOX 557	LEBANON	OR	97355	931126353	REAL ESTATE RENTAL	OR		N/A			0	0		N/A
NORTHWEST MEDICAL ISOTOPES LLC
815 NW 9TH ST STE 256	CORVALLIS	OR	97330	273007752	RESEARCH	OR	SAMARITAN HEALTH SERVICES	N/A			0	0
2750 HARRISON BLVD LLC
413 SW 13TH AVE STE 300	PORTLAND	OR	97205	274665571	REAL ESTATE RENTAL	OR		N/A			0	0		N/A
CASCADE VIEW MEDICAL OFFICE BUILDING LLC
PO BOX 3000	CORVALLIS	OR	973393000	300658805	REAL ESTATE RENTAL	OR	GOOD SAMARITAN HOSPITAL	EXCLUDED	-2371	885058	0	1	0.34000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	SAMARITAN HEALTH PLANS INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3600 NW SAMARITAN DRIVE	AddressLine1
City	CORVALLIS	City
State	OR	State
ZIP Code	97330	ZIPCode

Field	Value	IRS element (for citing)
EIN	930860860	EIN
Primary Activity	HEALTH INSURANCE CARRIER FOR THE COMMUNITY	PrimaryActivity
Legal Domicile State	OR	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SAMARITAN HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C	TypeOfEntity

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	0	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	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	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	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
INTERCOMMUNITY HEALTH PLANS INC
K	16272088	COST
SAMARITAN ENDOSCOPY CENTER LLC
A	344718	COST
SAMARITAN ENDOSCOPY CENTER LLC
N	144100	COST
SAMARITAN ENDOSCOPY CENTER LLC
O	144100	COST
SAMARITAN ENDOSCOPY CENTER LLC
R	444891	COST
CORVALLIS MEDICAL BUILDINGS LLC
A	47689	COST
CORVALLIS MEDICAL BUILDINGS LLC
R	76300	COST
CORVALLIS MEDICAL BUILDINGS LLC
J	427566	COST
HULL IMAGING LLC
A	168100	COST
HULL IMAGING LLC
N	638937	COST
HULL IMAGING LLC
R	858000	COST