2012-08-15T15:41:52-05:00 2011-09-30 FORDHAM GOODFELLOW LLP 233 SE Second Ave Hillsboro OR 971234016 990 2010-10-01 930430029 TUALITY HEALTHCARE TUAL 5036811579 335 SE EIGHTH AVENUE HILLSBORO OR 97123 Tim Fleischmann 5036811579 2012-08-15 1 Lester L Fordham 5036486651 2010 2016-02-24 21:20:13Z Richard Stenson 335 SE 8th Avenue Hillsboro OR 97123 179208837 0 X www.tuality.org X 1954 OR SEE ATTACHED STATEMENT 8 8 1527 213 200997 -276156 808384 1720526 178901606 176504665 972891 983646 0 0 180682881 179208837 231960 257200 0 0 88173025 95015612 0 0 0 86971521 82214902 175376506 177487714 5306375 1721123 142817260 142274448 69555483 75018748 73261777 67255700 X Tuality Healthcare's Mission is to provide health care to the community with respect for human dignity and without regard for the recipient's ability to pay. We believe that compassion encourages healing, that knowledge is the foundation of wellness, and that attention to quality and fiscal stability will enable us to continue to service the community. 0 0 171983497 256459 175747941 SEE SCHEDULE ATTACHED 171983497 1 1 0 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 204 1527 1 1527 0 1 1 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X X Tim Fleischmann - TUALITY HEALTHCAR 5036811570 335 SE EIGHTH AVE HILLSBORO OR 97123 EUGENE ZURBRUGG 5.00 X 0 0 0 FRED NACHTIGAL 4.00 X 0 0 0 CHARLES ROSENBLATT 4.00 X 0 0 0 MIKE FOGLIA 4.00 X 0 0 0 MARK ROSENBAUM 4.00 X 0 0 0 LEN BERGSTEIN 4.00 X 0 0 0 DARELL LUMACO 4.00 X 0 0 0 MIKE HUNDLEY 4.00 X 0 0 0 RICHARD STENSON 40.00 X 342793 0 62500 JOHN COLETTI JR 40.00 X 311522 0 21789 MANUEL BERMAN 40.00 X 186915 0 43929 EUNICE RECH 40.00 X 144593 0 16308 TIM FLEISCHMANN 40.00 X 164311 0 33000 TODD SADOWSKI 40.00 X 492550 0 0 JEREMIAH MURPHY 40.00 X 472196 0 16500 ROBERT SCHMIDT 40.00 X 453543 0 33000 GREGORY ROSENBLATT 40.00 X 451600 0 33000 JOHN AUSTIN 40.00 X 386516 0 16500 Marc Lewis MD 0.50 X 0 0 0 3406539 0 276526 10 0 1 0 SOUND INPATIENT PHYSICIANS 1123 PACIFIC AVENUE TACOMA WA 98402 CONTRACT HOSPITALISTS 1109845 ANESTHESIA ASSOCIATES NORTHWEST 6400 SE LAKE RD SUITE 130 PORTLAND OR 97222 CONTRACT CRNA 953464 THE OREGON CLINIC 975 SE SANDYSUITE 201 PORTLAND OR 97214 CARDIAC SURGERY PA COVERAGE 668443 COOPERATIVE PERFUSION SVC INC 9588 SW GRIBBLE CANBY OR 97013 PERFUSION SVCS 350400 NORTHWEST EMERGENCY PHYSICIANS PO BOX 634720 CINCINNATI OH 45263 MEDICAL DIRECTOR 197203 5 1720526 1720526 NON MCR/MCD HOSP REV 621110 149098139 149098139 CAFETERIA 621110 701387 701387 MANAGEMENT FEES 541610 199452 199452 BILLING SERVICE FEES 518210 1545 1545 26504142 26504142 176504665 983430 983430 216 216 179208837 175602281 200997 1685033 257200 257200 1457186 1457186 73436816 73436816 4035410 4035410 10247956 10066033 181923 5838244 5734603 103641 466892 176689 290203 113488 113488 8832323 7865155 967168 379200 379200 1409353 1116741 292612 7249882 7249882 459252 420204 39048 32199 32199 1557236 1557236 7852576 7067318 785258 1789372 1610435 178937 SUPPLIES 19970375 19938382 31993 BAD DEBT EXP - DIRECT W 17376129 17376129 EQUIPMENT RENTAL AND MA 5791650 5778231 13419 PROVIDER TAX 4281268 4281268 PROFESIONAL FEES 3165796 2450857 714939 1487911 1185708 302203 177487714 171983497 5504217 0 25018826 30611868 25930992 24618677 1042582 1246479 2674170 2631912 2288750 2221953 141918505 106230599 39954337 35687906 30564824 28652028 15342779 16603625 142817260 142274448 38299746 46967882 26781438 23274000 2046358 1120161 2427941 3656705 69555483 75018748 X 72918577 67128500 343200 127200 73261777 67255700 142817260 142274448 X 1721123 -7727200 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4442993 948326 -27010 23876 1332364 4008069 4402566 800425 255430 31410 984018 4442993 4473568 944880 24688 22124 1018446 4402566 0.62000 0.38000 0 1 1 2407626 2407626 54506333 41568684 12937649 2794766 732151 2062615 82011780 63929764 18082016 198000 198000 35687906 SECURITIES AND OTHER INVESTMENTS 28652028 F 28652028 OTHER ASSETS 16427125 INTEREST IN NET ASSETS OF FOUNDATION 76500 Goodwill 100000 16603625 AFFILIATES 3656705 3656705 179208837 177487714 1721123 -7727200 -7727200 -6006077 180150100 -372400 1313663 941263 179208837 0 179208837 175492057 0 175492057 1995657 1995657 177487714 Part XI, Line 8 - Other Adjustments: CHANGE IN INTEREST IN NET ASSETS UNDER FAS 136 -216,000. GAAP BAD DEBT EXPENSE IN EXCESS OF DIRECT WRITE OFF METHOD 1,995,656. ROUNDING EQUITY INCOME NET OF DISTRIBUTIONS OF JT VENTURES 930,396. CHANGE IN MINIMUM PENSION LIABILITY UNDER FAS 158 -10,448,100. NET ASSETS RELEASED FROM RESTRICTION 10,848. Part XII, Line 2d - Other Adjustments: EQUITY INCOME FROM JOINT VENTURES & SUBSIDIARIES 1,302,796. ROUNDING 267. NET ASSETS RELEASED FROM RESTRICTION 10,600. Part XIII, Line 4b - Other Adjustments: GAAP BAD DEBT EXPENSE IN EXCESS OF DIRECT WRITE OFF METHOD 1,995,656. ROUNDING 1. 1 1 X 1 X 1 X 1 1 1 0 1 1 4073160 4073160 0.02540 20138333 11308747 8829586 0.05510 24211493 11308747 12902746 0.08050 1900444 1900444 0.01190 249686 249686 0.00160 243133 72125 171008 0.00110 433402 433402 0.00270 2826665 72125 2754540 0.01730 27038158 11380872 15657286 0.09780 286427 286427 0.00180 286427 286427 0.00180 0 15817190 47268660 62949440 -15680780 X 1 1 2 1 Tuality Community Hospital

335 SE 8th Ave Hillsboro OR 97123

X X X 2 Tuality Forest Grove Hospital

1809 Maple Street Forest Grove OR 97116

X X X Not Required 2 14 Tuality Urgent Care at Reedville

7545 SE Tualatin Valley Hwy Hillsboro OR 97123

Urgent Care Tuality Healthplace

1200 NE 48th Ave Ste 7000 Hillsboro OR 97123

OP Therapy TualityOHSU Cancer Center

299 SE 9th Ave Hillsboro OR 97123

OP Radiation Therapy Tuality Home Health

3201 19th Ave Ste F Forest Grove OR 97116

Home Health Services Orenco Station Medical Plaza

6355 NE Cornell Rd Hillsboro OR 97123

MOB Tuality 8th Avenue Medical Plaza

364 SE 8th Ave Hillsboro OR 97123

MOB Tuality 7th Avenue Medical Plaza

333 SE 7th Ave Hillsboro OR 97123

MOB Tuality Forest Grove Medical Plaza

3201 19th Ave Forest Grove OR 97116

MOB Hillsboro Internal Medicine

364 SE 8th Ave Ste 301 Hillsboro OR 97123

Physician Offices North Plains Medical Clinic

10245 NW Glencoe Rd North Plains OR 97133

Physician Offices Northwest Ortho Surgery & Sport Medicine

21255 NW Jacobson Re Ste 500 Hillsboro OR 97124

Physician Offices Tuality Obstetrics & Gynecology

364 SE 8th Ave Ste 205 Hillsboro OR 97123

Physician Offices Westside Medical Clinic

21255 NW Jacobson Re Ste 500 Hillsboro OR 97124

Physician Offices Tuality Hillsboro Hematology & Oncology

364 SE 8th Ave Ste 105 Hillsboro OR 97123

Physician Offices Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 17376129. Part II: The Tuality Health Education Center is a hub for many community activities and organizations in the greater Hillsboro area. The facility provides meeting space for a number of community organizations, ranging from the Hillsboro Rotary Club to Washington County Community Action. The facility also plays host to dozens of Tuality sponsored classes and healthcare presentations. These range from classes on diabetes, yoga and care seat safety to presentations by doctors and other healthcare providers on topics as diverse as COPD, stroke prevention and weight-loss surgery. Tuality also provides free or low-cost blood pressure, cholesterol and blood glucose screenings at many community events. Part III, Line 9b: In addition to referencing and accessing our internal Tuality Financial Assistance program (before, during, and after services are rendered), we also recognize other Portland providers' (hospitals, physician, ambulance, DME, etc) financial assistance determination (with written proof). Part VI, Line 1: See attached Community Benefit Report Part VI, Line 2: Tuality Healthcare's leadership interacts with the citizens of western Washington County in a variety of ways. Tuality is actively involved as a sponsor in a long list of community events, from the Washington County Airshow, the premier airshow in the Pacific Northwest, to the North Plains Garlic Festival. In addition, we engage our residents through our many partnerships with a host of worthwhile organizations like Pacific University, Virginia Garcia Memorial Health Center, Essential Health Clinic, Hospice of Washington County and many others. Tuality strives to get feedback from our customers through surveys and questionnaires that tell us how well we are doing with current services, as well as what new and improved services may be needed by the community. Part VI, Line 3: Requests for financial assistance may be made at any point before, during, or after the provision of care. Information related to eligibility for financial assistance is located in the lobbies of the hospital and available on the Tuality.org website. Financial assistance requests may be proposed by sources other than the patient, such as the patient's physician, family members, community or religious groups, social services, or hospital personnel. Anyone wishing to make application for financial assistance with Tuality Healthcare will be given a Financial Assistance Application, which includes instructions on how to apply. All private pay admits are screened for Medicaid/Social Security disability coverage and a hold is placed on the account while we assist the patient and /or their family apply for government benefits. Part VI, Line 4: Tuality Healthcare serves a large geographic area of western Washington County that stretches from the suburban Portland cities of Aloha and Beaverton to the Coast Range. The market includes the cities of Hillsboro and Forest Grove, sites of Tuality's two hospitals, plus smaller towns such as Cornelius, Gaston, North Plains and Banks. This region is roughly 250,000 people and is one of the fastest growing areas in Oregon. In addition, Tuality is one of the region's largest employers with a staff of over 1,200. Tuality provides financial, material and medical assistance to many community partners in the region. Tuality Healthcare is designated a " Disproportionate Share Hospital" by the Centers for Medicare and Medicaid Services, due to the larger than normal percentage of care we provide to the low income and indigent population in our area. Part VI, Line 6: When it comes to community, everyone has a part to play. For us, it's an honor and a duty to help those near us receive the best medical care possible. That's why, since our beginnings in 1918, we've worked hard to provide quality, convenient care for people in western Washington County. Today, we're the only local, independent, community-governed healthcare system in the area, offering inpatient and outpatient treatment, specialty services, health education, and more.Of course, our goal isn't only to treat you when you're sick, but also to help you stay well. For that reason, you'll often find us at local events and other public places, offering free or low-cost health screenings and educational courses. For those who need it, we even provide transportation to and from medical appointments.Many of these services are offered at Tuality Health Education Center and other locations. We really are your neighbors! Many of our 1,400 employees live just a short distance from work.Our larger facilities include Tuality Community Hospital in Hillsboro and Tuality Forest Grove Hospital. In addition, we have numerous other medical centers and outpatient facilities. By keeping up with the latest advances in medical science, we've earned a sterling reputation for the quality of our heart, cancer, stroke, and diagnostic imaging services.In this way, we are able to offer the best possible medical care to the Tualatin Valley cities and communities in western Washington County, such as Aloha, Beaverton, Hillsboro, Forest Grove, Cornelius, and the smaller communities of the Coastal Range foothills. Part VI, Line 7: N/A Reports Filed With States Part VI, Line 7 OR 1 SEE ATTACHED SCHEDULE VARIOUS VARIOUS OR 12345 256459 VARIOUS COMMUNITY AND HEALTH ENRICHMENT 53 58 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Internal records document the award of grants or assistance and the intended use. X 0 1 0 0 0 0 0 0 0 RICHARD STENSON 342793 0 0 0 0 0 24000 0 38500 0 405293 0 0 0 JOHN COLETTI JR 311522 0 0 0 0 0 0 0 21789 0 333311 0 0 0 MANUEL BERMAN 186915 0 0 0 0 0 0 0 43929 0 230844 0 0 0 EUNICE RECH 144593 0 0 0 0 0 0 0 16308 0 160901 0 0 0 TIM FLEISCHMANN 164311 0 0 0 0 0 0 0 33000 0 197311 0 0 0 TODD SADOWSKI 492550 0 0 0 0 0 0 0 0 0 492550 0 0 0 JEREMIAH MURPHY 472196 0 0 0 0 0 0 0 16500 0 488696 0 0 0 ROBERT SCHMIDT 453543 0 0 0 0 0 0 0 33000 0 486543 0 0 0 GREGORY ROSENBLATT 451600 0 0 0 0 0 0 0 33000 0 484600 0 0 0 JOHN AUSTIN 386516 0 0 0 0 0 0 0 16500 0 403016 0 0 0 Part I, Line 4b Richard Stenson - $24,000 paid in the fiscal year ended 9/30/2011. Part I, Line 4b: Under the plan, Tuality Healthcare is obligated to contribute vested accrued benefits to the participant's plan account. Contributions to the participant's plan account are made on a monthly basis at an amount equal to two thousand dollars per month. Hospital Facility Authority of Hillsboro Oregon 930554495 432101CY7 2004-08-01 27432495 Refund of Series 1993 Bonds 0 0 0 27432495 115500 304910 1003472 2005 0 1 1 1 0 0 0 0 0 0 1 0 0 0 1 Form 990, Part VI, Section B, line 11 A copy of the 990 is reviewed by Tuality Healthcare's Chief Financial Officer. It is then presented to the Tuality Healthcare Board of Directors for review, prior to being filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by making it part of the employee's annual review. Board members are also required to review the policy annually. All afore said parties are required to certify that they have read the conflict of interest policy, have disclosed any potential conflicts of interest, and agree to immediately notify the Compliance Officer if a conflict should arise. Corrective actions are to be taken immediately to address any conflicts of interest. Form 990, Part VI, Section B, line 15 The Executive group's compensation is periodically reviewed every 3-5 yrs by an independent party, at the direction of the board of directors. The Tuality Healthcare HR department annually reviews compensation for all others. Form 990, Part VI, Section C, line 19 The organization's tax returns are made available for public inspection on the following website: Guidestar.org. Governing documents are made available upon written request to the Chief Financial Officer of Tuality Healthcare. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: CHANGE IN INTEREST IN NET ASSETS UNDER FAS 136 -216,000. GAAP BAD DEBT EXPENSE IN EXCESS OF DIRECT WRITE OFF METHOD 1,995,656. ROUNDING EQUITY INCOME NET OF DISTRIBUTIONS OF JT VENTURES 930,396. CHANGE IN MINIMUM PENSION LIABILITY UNDER FAS 158 -10,448,100. NET ASSETS RELEASED FROM RESTRICTION 10,848. Total to Form 990, Part XI, Line 5: -7,727,200. Tuality Healthcare Foundation 334 SE 8th Avenue Hillsboro OR 97123 930751507 Charitable Foundation OR 501(C)(3) 7 Tuality Healthcare 0 Tuality Property Management PO Box 309 Hillsboro OR 97123 930840810 Exempt Organization Property Management OR 501(C)(2) N/A Tuality Healthcare 0 Tuality Management Systems Inc 335 SE 8th Avenue Hillsboro OR 97123 930840778 Other Medical Services OR Tuality Healthcare C -8534 1297856 1.00000 0 0 1 1 0 0 0 0 0 1 1 1 1 1 0 0 0 1 Tuality Management Systems Inc K 199452 Actual Cost Tuality Property Management K 424356 Actual Cost Tuality Healthcare Foundation C 1254000 Cash