2011-08-12T14:57:46-05:00 2010-09-30 FORDHAM GOODFELLOW LLP 233 SE Second Ave Hillsboro OR 971234016 990 2009-10-01 930430029 TUALITY HEALTHCARE TUAL 5036811579 335 SE EIGHTH AVENUE HILLSBORO OR 97123 Tim Fleischmann 5036811579 2011-08-11 1 Lester L Fordham 5036486651 2009 2016-02-24 21:20:13Z Richard Stenson 335 SE 8th Avenue Hillsboro OR 97123 180682881 0 X www.tuality.org X 1954 OR SEE ATTACHED STATEMENT 9 8 1518 128 202146 -298897 799179 808384 169030638 178901606 987175 972891 0 170816992 180682881 317873 231960 0 87135352 88173025 0 0 85568667 86971521 173021892 175376506 -2204900 5306375 137608918 142817260 67246311 69555483 70362607 73261777 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 169928051 231960 178020051 SEE SCHEDULE ATTACHED 169928051 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 204 0 1 1518 1 1 1 0 0 0 0 0 0 0 0 0 0 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X X Tim Fleischmann - TUALITY HEALTHCARE 5036811570 335 SE EIGHTH AVE HILLSBORO OR 97123 RICHARD STENSON 40.00 X X X 320911 0 0 JOHN COLETTI JR 40.00 X X X 339145 0 0 MANUEL BERMAN 40.00 X X X 234422 0 0 EUNICE RECH 40.00 X X X 157595 0 0 TIM FLEISCHMANN 40.00 X X X 189147 0 0 EUGENE ZURBRUGG 0.50 X 0 0 0 FRED NACHTIGAL 0.50 X 0 0 0 CHARLES ROSENBLATT 0.50 X 0 0 0 MIKE FOGLIA 0.50 X 0 0 0 MARK ROSENBAUM 0.50 X 0 0 0 LEN BERGSTEIN 0.50 X 0 0 0 DARELL LUMACO 0.50 X 0 0 0 MIKE HUNDLEY 0.50 X 0 0 0 PATRICK O'LEARY 40.00 X 350850 0 0 JOHN AUSTIN 40.00 X 375445 0 0 ROBERT SCHMIDT 40.00 X 474944 0 0 JEREMIAH MURPHY 40.00 X 491792 0 0 TODD SADOWSKI 40.00 X 490279 0 0 3424530 0 0 10 0 1 0 SOUND INPATIENT PHYSICIANS 1123 PACIFIC AVENUE TACOMA WA 98402 CONTRACT HOSPITALISTS 1184071 OHSU CARDIOLOGY DIVISION 3181 SW SAM JACKSON SCHOOL RD PORTLAND OR 97239 CONTRACT CARDIOLOGY PHYSICIANS 598516 2 808384 808384 NONMCR/MCD HOSP REV 153559936 153559936 CAFETERIA 679409 679409 MANAGEMENT FEES 541610 193644 193644 BILLING SERVICE FEES 518210 8502 8502 24460115 24460115 178901606 972675 972675 216 216 180682881 178020051 202146 1652300 231960 231960 1265930 1265930 69890098 69890098 3494004 3494004 7628261 7506846 121415 5894732 5800909 93823 351281 101155 250126 97348 97348 10397694 9414386 983308 420781 420781 1452667 1139087 313580 7234988 7234988 381255 359239 22016 11835 11835 1762709 1762709 8384452 7546007 838445 2246190 2021571 224619 SUPPLIES 22168789 22138258 30531 BAD DEBT EXP - DIRECT W 17012852 17012852 EQUIPMENT RENTAL AND MA 5302206 5288183 14023 PROFESIONAL FEES 4170965 3318341 852624 PROVIDER TAX 3810430 3810430 1765079 1436247 328832 175376506 169928051 5448455 0 17451246 25018826 24448224 25930992 1240312 1042582 2513984 2674170 2807914 2288750 138369721 98415384 45595963 39954337 29108198 30564824 14443077 15342779 137608918 142817260 32502586 38299746 30548037 26781438 2866685 2046358 1329003 2427941 67246311 69555483 X 70112407 72918577 250200 343200 70362607 73261777 137608918 142817260 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4402566 800425 255430 31410 984018 4442993 4473568 944880 24688 22124 1018446 4402566 0.00000 0.54700 0.45300 0 1 1 2407626 2407626 54506333 39331672 15174661 2180374 695552 1484822 78955388 58388160 20567228 320000 320000 39954337 SECURITIES AND OTHER INVESTMENTS 30564824 F 30564824 OTHER ASSETS 15010479 INTEREST IN NET ASSETS OF FOUNDATION 332300 15342779 AFFILIATES 2427941 2427941 180682881 175376506 5306375 926147 -1502936 -1830416 -2407205 2899170 182500800 926147 891772 1817919 180682881 0 180682881 178255400 596609 596609 177658791 -2282285 -2282285 175376506 Part XI, Line 8 - Other Adjustments: CHANGE IN INTEREST IN NET ASSETS UNDER FAS 136: 93000. GAAP BAD DEBT EXPENSE IN EXCESS OF DIRECT WRITE OFF METHOD: -2282199. ROUNDING: -26. EQUITY INCOME NET OF DISTRIBUTIONS OF JT VENTURES: 886909. CHANGE IN MINIMUM PENSION LIABILITY UNDER FAS 158: -532900. NET ASSETS RELEASED FROM RESTRICTION: 4800. Part XII, Line 2d - Other Adjustments: EQUITY INCOME FROM JOINT VENTURES & SUBSIDIARIES: 886909. ROUNDING: 63. NET ASSETS RELEASED FROM RESTRICTION : 4800. Part XIII, Line 4b - Other Adjustments: GAAP BAD DEBT EXPENSE IN EXCESS OF DIRECT WRITE OFF METHOD: -2282199. ROUNDING: -86. 1 1 X 1 X 1 X 1 1 1 0 1 1 3868546 3868546 0.02440 17742162 10072511 7669651 0.04840 21610708 10072511 11538197 0.07280 2103373 2103373 0.01330 269789 269789 0.00170 433228 193991 239237 0.00150 403170 403170 0.00250 3209560 193991 3015569 0.01900 24820268 10266502 14553766 0.09180 14594 14594 0.00010 14594 14594 0.00010 0 19295100 0 47677026 62712678 -15035652 X 1 1 Tuality Healthcare

335 SE 8th Ave Hillsboro OR 97123

X X X Tuality Urgent Care at Reedville

7545 SE Tualatin Valley Hwy Hillsboro OR 97123

X Tuality Healthplace

1200 NE 48th Ave Ste 7000 Hillsboro OR 97123

OP therapy Tuality Forest Grove Hospital

1809 Maple St Forest Grove OR 97116

X X X 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 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 5: 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 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 OR 1 SEE ATTACHED SCHEDULE VARIOUS VARIOUS OR 12345 231960 VARIOUS COMMUNITY AND HEALTH ENRICHMENT 54 6 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 278910 0 0 0 42001 0 0 0 0 0 320911 0 0 0 JOHN COLETTI JR 319145 0 0 0 20000 0 0 0 0 0 339145 0 0 0 MANUEL BERMAN 190423 0 0 0 43999 0 0 0 0 0 234422 0 0 0 EUNICE RECH 141621 0 0 0 15974 0 0 0 0 0 157595 0 0 0 TIM FLEISCHMANN 156147 0 0 0 33000 0 0 0 0 0 189147 0 0 0 PATRICK O'LEARY 334350 0 0 0 16500 0 0 0 0 0 350850 0 0 0 JOHN AUSTIN 358945 0 0 0 16500 0 0 0 0 0 375445 0 0 0 ROBERT SCHMIDT 458444 0 0 0 16500 0 0 0 0 0 474944 0 0 0 JEREMIAH MURPHY 475292 0 0 0 16500 0 0 0 0 0 491792 0 0 0 TODD SADOWSKI 483294 0 0 0 6985 0 0 0 0 0 490279 0 0 0 Part I, Line 4b: Richard Stenson - $0 paid in the fiscal year ended 9/30/2010. 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 27432495 115500 26008613 304910 1003472 2005 0 1 1 1 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. Tuality Healthcare Foundation 334 SE 8th Avenue Hillsboro OR 97123 930751507 Charitable Foundation OR 501(C)(3) 11a N/A Tuality Property Management PO Box 309 Hillsboro OR 97123 930840810 Exempt Organization Property Management OR 501(C)(2) N/A N/A Tuality Management Systems Inc 335 SE 8th Avenue Hillsboro OR 97123 930840778 Other Medical Services OR Tuality Healthcare C 100 100 1.00000 0 0 0 1 0 0 0 0 0 1 1 1 1 1 0 0 0 1 Tuality Management Systems Inc K 193644