SILVERTON HEALTH: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- SILVERTON HEALTH (EIN 93-0281321)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201132279349304378
- Schema version
- 2009v1.7
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T16:28:53-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SW Broadway 1200 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97205 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930281321 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SILVERTON HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SILV | NameControl |
| Phone | 5038731500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 342 FAIRVIEW STREET | AddressLine1 |
| City | SILVERTON | City |
| State | OR | State |
| ZIP Code | 97381 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFF FRITSCHE | Name |
| Title | CFO | Title |
| Phone | 5038731500 | Phone |
| Date Signed | 2011-08-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wendy Campos | Name |
| Phone | 5032421447 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RICHARD CAGEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 342 FAIRVIEW STREET | AddressLine1 |
| City | SILVERTON | City |
| State | OR | State |
| ZIP Code | 97381 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 111387020 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.SILVERTONHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1918 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | Through Silverton Hospital Network we come together to improve the health of our communities. Recognizing our responsibility for careful use of resources, it is our misson to encourage wellness and deliver quality health care, to organize ourselves as a collaborative team fostering integrity, accountability and innovation, and to create an environment that promotes compassion and recognizes the dignity of all, with sensitivity to the values and cultures of those who entrust us with their care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 932 | TotalNbrEmployees |
| Total Nbr Volunteers | 286 | TotalNbrVolunteers |
| Total Gross UBI | 1495092 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1497869 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 434091 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 153905 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 96060170 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 101000335 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 128992 | InvestmentIncomePriorYear |
| Investment Income Current Year | 25603 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3665350 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3746819 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 100288603 | TotalRevenuePriorYear |
| Total Revenue Current Year | 104926662 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 104476 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 111590 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 52699533 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 54884334 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 44435041 | OtherExpensePriorYear |
| Other Expenses Current Year | 46855009 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 97239050 | TotalExpensesPriorYear |
| Total Expenses Current Year | 101850933 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3049553 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3075729 | RevenuesLessExpensesCY |
| Total Assets BOY | 60187424 | TotalAssetsBOY |
| Total Assets EOY | 62227077 | TotalAssetsEOY |
| Total Liabilities BOY | 19507938 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 18299135 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 40679486 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 43927942 | NetAssetsOrFundBalancesEOY |
| Mission Description | Through Silverton Hospital Network we come together to improve the health of our communities. Recognizing our responsibility for careful use of resources, it is our misson to encourage wellness and deliver quality health care, to organize ourselves as a collaborative team fostering integrity, accountability and innovation, and to create an environment that promotes compassion and recognizes the dignity of all, with sensitivity to the values and cultures of those who entrust us with their care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 100899574 | Expense |
| Grants | 111590 | Grants |
| Revenue | 103255441 | Revenue |
| Description | GENERAL HOSPITAL INPATIENT AND OUTPATIENT CARE AND EDUCATION FOR PATIENTS IN THE LOCAL COMMUNITY, INCLUDING MEDICARE AND MEDICAID PATIENTS AND CHARITY CARE. CHARGES WRITTEN OFF DUE TO INADEQUATE REIMBURSEMENT - $53.7 MILLION. CHARGES FORGONE FOR CHARITY CARE - $12.1 MILLION. | Description |
| Total Program Service Expense | 100899574 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 100 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 932 | 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFF FRITSCHE CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5038731548 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 342 FAIRVIEW STREET | AddressLine1 |
| City | SILVERTON | City |
| State | OR | State |
| ZIP Code | 97381 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| GARY SIMON | |||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | |
| GAYLE GOSCHIE | |||||||
| VICE-CHAIR | 2.00 | X | X | 0 | 0 | 0 | |
| JOHN WEBSTER | |||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | |
| CORY CROSS | |||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | |
| DAVE BUCK | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| BOB ENGLE | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| FRANK GOLDEN MD | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| DARCY RUEF | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| CLINT SANFORD MD | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| BETH DAVISSON | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JANE WYNN | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| WILLIAM WINTER | |||||||
| PRESIDENT | 40.00 | X | 876110 | 0 | 20028 | ||
| JEFF LORENZ | |||||||
| VP SHARED SERVICES | 40.00 | X | 242744 | 0 | 35413 | ||
| ROB JOHNSON | |||||||
| VP CLINICS | 40.00 | X | 142411 | 0 | 9703 | ||
| JEFF FRITSCHE | |||||||
| CFO | 40.00 | X | 0 | 0 | 0 | ||
| TERRI MERRITT WORDEN | |||||||
| VP WELLSPRING | 40.00 | X | 139175 | 0 | 15260 | ||
| DAVID THORSETT MD | |||||||
| DOCTOR | 40.00 | 646561 | 0 | 24978 | X | ||
| DAVID FORSYTHE MD | |||||||
| DOCTOR | 40.00 | 483224 | 0 | 27910 | X | ||
| ROBERT CHISHOLM MD | |||||||
| DOCTOR | 36.00 | 419505 | 0 | 28151 | X | ||
| RICHARD BLOCK MD | |||||||
| DOCTOR | 40.00 | 411527 | 0 | 34416 | X | ||
| KENNETH KOLARSKY MD | |||||||
| DOCTOR | 40.00 | 364310 | 0 | 14057 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3725567 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 209916 | TotalOtherCompensation |
| Number Individuals GT100 K | 72 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Providence Health System - Oregon | |||||
| 47th Ave Suite 260 | Portland | OR | 97213 | Billing Services | 1052733 |
| ProvidenceSilverton Rehab LLC | |||||
| PO BOX 3290 | portland | OR | 97208 | Patient Services | 473153 |
| Shiftwise | |||||
| PO Box 70870 | St Paul | MN | 55170 | Staffing | 338672 |
| Netscript Inc | |||||
| 235 CR 3520 | Clarksville | AR | 72830 | Transcription | 281046 |
| Donald Graham MD | |||||
| 127 Del Prado | Lake Oswego | OR | 97035 | Physician | 280673 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Fundraising Events | 3379 | FundraisingEvents |
| All Other Contributions | 150526 | AllOtherContributions |
| Noncash Contributions | 23919 | NoncashContributions |
| Total Contributions | 153905 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 101000335 | TotalRevenueColumn |
| Related Or Exempt Function Income | 101000335 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 101000335 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 104993 | TotalRevenueColumn |
| Exclusion | $104,993 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6353219 | Securities |
| Other | 3590 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6436009 | Securities |
| Other | 190 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -82790 | Securities |
| Other | 3400 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -79390 | TotalRevenueColumn |
| Exclusion | -$79,390 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 20780 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 3379 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 24159 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3379 | TotalRevenueColumn |
| Exclusion | -$3,379 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| OTHER OPERATING REV | 900099 | 3696452 | 2201360 | 1495092 |
| INCOME FROM SUBSIDIARY | 900099 | 53746 | 53746 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3750198 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 104926662 | TotalRevenueColumn |
| Related Or Exempt Function Income | 103255441 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1495092 | UnrelatedBusinessRevenue |
| Exclusion | $22,224 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111590 | Total |
| Program Services | 111590 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1307231 | Total |
| Program Services | 629123 | ProgramServices |
| Management And General | 678108 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43261931 | Total |
| Program Services | 43261931 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1605382 | Total |
| Program Services | 1605382 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5734598 | Total |
| Program Services | 5734598 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2975192 | Total |
| Program Services | 2937819 | ProgramServices |
| Management And General | 37373 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 153895 | Total |
| Management And General | 153895 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81983 | Total |
| Management And General | 81983 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5875603 | Total |
| Program Services | 5875603 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 218013 | Total |
| Program Services | 218013 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 728128 | Total |
| Program Services | 728128 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 397495 | Total |
| Program Services | 397495 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3547568 | Total |
| Program Services | 3547568 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77832 | Total |
| Program Services | 77832 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155624 | Total |
| Program Services | 155624 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 379686 | Total |
| Program Services | 379686 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3913527 | Total |
| Program Services | 3913527 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 764320 | Total |
| Program Services | 764320 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| CHARITY CARE | 12094170 | 12094170 |
| SUPPLIES | 11673890 | 11673890 |
| BAD DEBT EXPENSE | 5033353 | 5033353 |
| OTHER | 1327711 | 1327711 |
| Equipment Rent | 432211 | 432211 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101850933 | Total |
| Program Services | 100899574 | ProgramServices |
| Management And General | 951359 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6937053 | BOY |
| EOY | 8370163 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14382272 | BOY |
| EOY | 13610102 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 141945 | BOY |
| EOY | 98518 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1758705 | BOY |
| EOY | 1751521 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1266817 | BOY |
| EOY | 1011981 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 64765053 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 36485029 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30158231 | BOY |
| EOY | 28280024 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30886 | BOY |
| EOY | 206197 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5511515 | BOY |
| EOY | 8898571 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60187424 | BOY |
| EOY | 62227077 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9665604 | BOY |
| EOY | 9356656 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8623685 | BOY |
| EOY | 8072652 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 280822 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 937827 | BOY |
| EOY | 869827 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19507938 | BOY |
| EOY | 18299135 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40679486 | BOY |
| EOY | 43927942 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40679486 | BOY |
| EOY | 43927942 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60187424 | BOY |
| EOY | 62227077 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2768949 | OtherCostOrOtherBasis |
| Book Value | 2768949 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29795033 | OtherCostOrOtherBasis |
| Depreciation | 11872380 | Depreciation |
| Book Value | 17922653 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 779035 | OtherCostOrOtherBasis |
| Depreciation | 514277 | Depreciation |
| Book Value | 264758 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31029705 | OtherCostOrOtherBasis |
| Depreciation | 24098372 | Depreciation |
| Book Value | 6931333 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 392331 | OtherCostOrOtherBasis |
| Book Value | 392331 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 28280024 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 109134 |
| OTHER ASSETS | 123882 |
| ASSETS LIMITED AS TO USE | 8665555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 8898571 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED MEDICAL MALPRACTICE LIABILITY | Description |
| Amount | $869,827 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 869827 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | The Hospital adopted the provisions of Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740-10, Accounting for Uncertainty in Income Taxes, on October 1, 2007. The Hospital had no unrecognized tax benefits at September 30, 2010 and at September 30, 2009. The Hospital recognizes interest accrued and penalties related to unrecognized tax benefits as an administrative expense. During the years ended September 30, 2010 and 2009, the Hospital recognized no interest and penalties. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | WELLSPRING HEART GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 24159 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 3379 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 20780 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 24159 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 24159 | GrossReceiptsTotal |
| Charitable Contributions Total | 3379 | CharitableContributionsTotal |
| Gross Revenue Total Events | 20780 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 24159 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 24159 | DirectExpenseSummaryEvents |
| Net Income Summary | -3379 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| 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) |
|---|---|---|
| Persons Served | 4043 | PersonsServed |
| Total Community Benefit Expense | 4177673 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 109556 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4068117 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04200 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17497 | PersonsServed |
| Total Community Benefit Expense | 14783789 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13923403 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 860386 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00890 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 21540 | PersonsServed |
| Total Community Benefit Expense | 18961462 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14032959 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4928503 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05090 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 34 | NumberOfActivitiesOrPrograms |
| Persons Served | 37050 | PersonsServed |
| Total Community Benefit Expense | 1288092 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 192236 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1095856 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01130 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 21 | NumberOfActivitiesOrPrograms |
| Persons Served | 161 | PersonsServed |
| Total Community Benefit Expense | 208386 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 208386 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 9031 | PersonsServed |
| Total Community Benefit Expense | 426901 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 426901 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Persons Served | 12722 | PersonsServed |
| Total Community Benefit Expense | 278521 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 79 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 278442 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 73 | NumberOfActivitiesOrPrograms |
| Persons Served | 58964 | PersonsServed |
| Total Community Benefit Expense | 2201900 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 192315 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2009585 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02080 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 73 | NumberOfActivitiesOrPrograms |
| Persons Served | 80504 | PersonsServed |
| Total Community Benefit Expense | 21163362 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14225274 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6938088 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07170 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 100 | PersonsServed |
| Total Community Building Expense | 7097 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 7097 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 583 | PersonsServed |
| Total Community Building Expense | 17668 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 17668 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 1379 | PersonsServed |
| Total Community Building Expense | 11766 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 50 | DirectOffsettingRevenue |
| Net Community Building Expense | 11716 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Persons Served | 1145 | PersonsServed |
| Total Community Building Expense | 84274 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 84274 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 20 | NumberOfActivitiesOrPrograms |
| Persons Served | 3207 | PersonsServed |
| Total Community Building Expense | 120805 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 50 | DirectOffsettingRevenue |
| Net Community Building Expense | 120755 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $5,033,353 | BadDebtExpenseAmount |
| Amount Attributable To | 1693069 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6473694 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8154605 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1680911 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SILVERTON HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 342 FAIRVIEW STREET | AddressLine1 |
| City | SILVERTON | City |
| State | OR | State |
| ZIP Code | 97381 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Part III, Line 4: THE ORGANIZATION UTILIZES A COST ACCOUNTING SYSTEM FOR DETERMINING THE ASSOCIATED COST OF PROVIDING SERVICES TO PATIENTS WITHOUT INSURANCE THAT ARE SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS. THAT PERCENTAGE IS THEN APPLIED TO THE TOTAL BAD DEBT EXPENSE PER THE GENERAL LEDGER (BASED ON CHARGES) TO DETERMINE THE ASSOCIATED COST. COLLECTIONS FROM THE PATIENT/GUARANTOR ARE NETTED AGAINST THAT COST TO DETERMINE A NET COST.ANY COLLECTIONS RECEIVED ON ACCOUNTS THAT WERE WRITTEN OFF TO BAD DEBT (EITHER PARTIALLY OR IN FULL) WERE NETTED AGAINST THE COST OF PROVIDING THE SERVICES TO THE PATIENT IN ORDER TO DETERMINE A NET COST.THE ORGANIZATION CURRENTLY DOES NOT HAVE THE SYSTEMS NECESSARY TO REASONABLY ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY.THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTIONS INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: SILVERTON HOSPITAL'S MISSION IS TO PROVIDE QUALITY HEALTHCARE SERVICES AND LEADERSHIP IN PROMOTING HEALTH IMPROVEMENT TO ALL PERSONS IN ITS SERVICE AREA ON A NON-DISCRIMINATORY BASIS AND WITHOUT REGARD TO ABILITY TO PAY. IN KEEPING WITH ITS COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, THE HOSPITAL PROVIDES CARE TO INDIVIDUALS COVERED BY THE MEDICARE PROGRAM IN SPITE OF THE FACT THAT THE COST OF PROVIDING THOSE SERVICES EXCEEDS THE REVENUE RECEIVED. THE SHORTFALL THAT THE HOSPITAL WAS REQUIRED TO ABSORB TOTALED $2,424,430 (INCLUDING SHORTFALL ARISING FROM MEDICARE ADVANTAGE). THIS CONTINUED COMMITMENT SHOULD BE TREATED AS A COMPONENT OF THE HOSPITAL'S COMMUNITY BENEFIT.IN ADDITION TO PROVIDING SERVICES TO MEDICARE BENEFICIARIES UNDER THE TRADITIONAL FEE FOR SERVICE PROGRAM, THE ORGANIZATION ALSO PROVIDES SERVICES TO MEDICARE BENEFICIARIES THROUGH VARIOUS MEDICARE ADVANTAGE PLANS. THE ORGANIZATION REALIZED A SHORTFALL OF COSTS IN EXCESS OF NET REVENUE OF $553,594 FOR BENEFICIARIES COVERED THROUGH MEDICARE ADVANTAGE PLANS, IN ADDITION TO THE SHORTFALLS REPORTED ABOVE ATTRIBUTABLE TO MEDICARE FEE FOR SERVICE BENEFICIARIES.THE ORGANIZATION UTILIZES A COST ACCOUNTING SYSTEM FOR DETERMINING THE ASSOCIATED COST OF PROVIDING SERVICES TO PATIENTS BY INDIVIDUAL PATIENT ACCOUNT. THE ACCOUNTS ARE THEN AGGREGATED FOR ALL PATIENT SEGMENTS BOTH BY TYPE OF SERVICE (INPATIENT, OUTPATIENT, EMERGENCY, ETC) AS WELL AS BY PAYOR (PRIVATE INSURANCE, MEDICARE, MEDICAID, SELF PAY, ETC) IN ORDER TO DETERMINE THE COST OF PROVIDING SERVICES TO ALL PATIENTS.THE COSTING METHODOLOGY USED FOR DETERMINING MEDICARE ALLOWABLE COSTS IS THAT REQUIRED BY CMS IN PREPARATION OF FORM CMS-2552. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: SILVERTON HOSPITAL NETWORK STRIVES TO PROVIDE ACCURATE AND TIMELY SERVICE WHEN BILLING AN INSURANCE COMPANY OR PATIENT DIRECTLY. EVERY BILL AND STATEMENT INCLUDES INFORMATION ABOUT HOW TO CONTACT FINANCIAL REPRESENTATIVES AND ARRANGE PAYMENT PLANS. WE ARE COMMITTED TO FINDING WAYS TO HELP EVERY PATIENT PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE RESPONSIBLE WITHOUT EXPERIENCING AN OVERWHELMING FINANCIAL BURDEN. IN ADDITION TO MAKING OUR BILLING PROCESS EASY TO UNDERSTAND AND ENSURING READY ACCESS TO CHARITY CARE AND FINANCIAL ASSISTANCE, WE ARE ABLE TO PROVIDE PATIENT COST INFORMATION IN ADVANCE OF SERVICES OR TREATMENT. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: WE REVIEWED NATIONAL, STATE AND LOCAL HEALTH NEEDS ASSESSMENTS, GOALS AND ACTION PLANS TO IDENTIFY THE NEEDS OF OUR COMMUNITY AND INCORPORATED THOSE NEEDS INTO OUR CURRENT PLANS. WE ALSO WORK WITH LOCAL NOT-FOR-PROFIT COMMUNITY ORGANIZATIONS AND LOCAL SCHOOLS TO IDENTIFY ADDITIONAL NEEDS. FINALLY, WE RECEIVE DIRECT REQUESTS (VIA E-MAIL, CALLS, LETTERS) FROM STATE, LOCAL AND NOT-FOR-PROFIT GROUPS/ORGANIZATIONS ASKING US TO ASSIST THEM IN MEETING OTHER HEALTH NEEDS. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: ALL PATIENTS INQUIRING ABOUT FINANCIAL ASSISTANCE AND/OR CHARITY CARE ARE REFERRED TO THE FINANCIAL COUNSELORS WHERE THE PATIENT IS THEN PROVIDED WITH DETAILED INFORMATION ON THE APPLICATION AND REQUIREMENTS NEEDED TO SUPPORT CHARITY CARE ELIGIBILITY AND DETERMINATION. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: SILVERTON HOSPITAL NETWORK DEFINES ITS PRIMARY SERVICE AREA BY THE FOLLOWING ZIPCODES: 97381, 97362, 97071, 97038, 97375, 97026, 97032, 97303, 97305, 97373 AND 97317. THIS INCLUDES THE CITIES OF SILVERTON, MT. ANGEL, WOODBURN, GERVAIS, HUBBARD, SCOTTS MILLS, ST. BENEDICT, MOLALLA, KEIZER AND PARTS OF SALEM. OUR COVERAGE STRETCHES OVER BOTH MARION AND CLACKAMAS COUNTIES. RESIDENTS OF OUR COMMUNITY ARE PRIMARILY CAUCASIAN AND HISPANIC. THERE IS A LARGE MIGRANT WORKER POPULATION IN THIS AREA AND SOME OF OUR SERVICE AREA INCLUDES MEDICALLY UNDERSERVED AREAS AS WELL AS HEALTH PROFESSIONAL SHORTAGE AREAS. IN ADDITION, WE HAVE AN UNCHARACTERISTICALLY LARGE POPULATION OF SENIORS IN SOME PORTIONS OF OUR SERVICE AREA, SPECIFICALLY IN WOODBURN AND THE SURROUNDING AREAS. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: PHYSICAL IMPROVEMENTS AND HOUSING: SUPPORTING THE DEVELOPMENT OF A LOCAL SENIOR CENTER PROMOTES THE HEALTH OF OUR COMMUNITY BY PROVIDING SHELTER, PHYSICAL ACTIVITY, SOCIAL INTERACTION, SENSE OF COMMUNITY AND EDUCATION TO OUR LOCAL SENIORS. THESE THINGS ARE ALL KNOWN TO ATTRIBUTE TO HEALTH AND WELLNESS. STAFF SERVING ON COMMUNITY HOUSING BOARDS AND WITH LOCAL LANGUAGE GROUPS BETTERS COMMUNITY HEALTH BY USING HEALTH EXPERTISE TO BETTER THE ROOT CAUSES OF POVERTY AND HOMELESSNESS.ECONOMIC DEVELOPMENT: PARTICIPATION IN LOCAL CHAMBERS OF COMMERCE AND ECONOMIC DEVELOPMENT GROUPS BETTERS COMMUNITY HEALTH BY SUPPORTING THE GROWTH OF JOBS IN OUR COMMUNITY, ENABLING THE UNEMPLOYED TO FIND WORK, AND FROM THAT, THE ABILITY TO AFFORD HEALTHCARE AND FOOD/SHELTER FOR THEIR FAMILIES.COMMUNITY SUPPORT: BY FINANCIALLY SUPPORTING AND DONATING FUNDS/SPACE TO THE LOCAL BOYS AND GIRLS CLUB AND VARIOUS SCHOOLS IN OUR SERVICE AREA, SHN BETTERS COMMUNITY HEALTH BY SUPPORTING THOSE PLACES WHICH GIVE CHILDREN A SAFE PLACE FOR PHYSICAL ACTIVITY, ACCESS TO BETTER NUTRITION, AND ACCESS TO FREE HEALTH SERVICES LIKE NURSES AND COUNSELING.WORKFORCE DEVELOPMENT: SHN STAFF ROUTINELY ALLOW STUDENTS TO JOB SHADOW THEM WHILE THEY WORK, OFFER TOURS OF THE HOSPITAL TO YOUNG CHILDREN, AND PARTICIPATE IN HIGH SCHOOL CAREER FAIRS. THROUGH THIS PARTICIPATION, THE HOSPITAL NETWORK HOPES TO EDUCATE LOCAL YOUTH ABOUT HEALTHCARE CAREERS, THE IMPORTANCE OF GOING TO COLLEGE, AND THE HOSPITAL PROCESS IN HOPES THAT THEY WILL FEEL SAFE IN A HEALTHCARE ENVIRONMENT AND POSSIBLY PURSUE A HEALTHCARE CAREER. OREGON CURRENTLY HAS A LARGE SHORTAGE OF HEALTHCARE WORKERS. | CommunityBuildingActivities |
| Reports Filed With States | OR | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| SILVERTON AREA SENIORS | ||||||||||
| 402 E Main St | Silverton | OR | 97381 | 931180119 | 501(C)(3) | 5000 | Support the welfare of Silverton seniors | |||
| SILVERTON AREA COMMUNITY AID | ||||||||||
| 421 S Water St | Silverton | OR | 97381 | 930884237 | 501(C)(3) | 1000 | Supply food for the needy | 4604 | fmv | food donation |
| SALUD MEDICAL CENTER | ||||||||||
| 3896 Beverly Ave NE | SALEM | OR | 97305 | 911019392 | 501(C)(3) | 42432 | Community Medical Care | |||
| WOODBURN KIWANIS | ||||||||||
| PO BOX 1046 | WOOdburn | OR | 97071 | 936037102 | 501(C)(3) | Provide meeting place to plan community activities | 7050 | fmv | room rentals | |
| AMERICAN CANCER SOCIETY | ||||||||||
| PO BOX 22538 | OKLAHOMA CITY | OK | 73123 | 841316555 | 501(C)(3) | 12853 | sponsorship of a relay for life team | |||
| ROTARY INTERNATIONAL WOODBURN | ||||||||||
| PO BOX 247 | Woodburn | OR | 97071 | 936032666 | 501(C)(4) | Provide meeting place to plan community activities | 13224 | fmv | room rentals | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
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: The grants and assistance provided to local organizations are considered to be donation-type contributions. Such contributions are generally made to section 501(c)(3) tax-exempt organizations. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM WINTER | |||||||||||||
| 330801 | 0 | 150 | 0 | 545159 | 0 | 17948 | 0 | 2080 | 0 | 896138 | 0 | 0 | 0 |
| JEFF LORENZ | |||||||||||||
| 227594 | 0 | 15150 | 0 | 0 | 0 | 18008 | 0 | 17405 | 0 | 278157 | 0 | 0 | 0 |
| ROB JOHNSON | |||||||||||||
| 142261 | 0 | 150 | 0 | 0 | 0 | 3329 | 0 | 6374 | 0 | 152114 | 0 | 0 | 0 |
| TERRI MERRITT WORDEN | |||||||||||||
| 129025 | 0 | 10150 | 0 | 0 | 0 | 0 | 0 | 15260 | 0 | 154435 | 0 | 0 | 0 |
| DAVID THORSETT MD | |||||||||||||
| 646411 | 0 | 150 | 0 | 0 | 0 | 7573 | 0 | 17405 | 0 | 671539 | 0 | 0 | 0 |
| DAVID FORSYTHE MD | |||||||||||||
| 483074 | 0 | 150 | 0 | 0 | 0 | 12650 | 0 | 15260 | 0 | 511134 | 0 | 0 | 0 |
| ROBERT CHISHOLM MD | |||||||||||||
| 419355 | 0 | 150 | 0 | 0 | 0 | 11900 | 0 | 16251 | 0 | 447656 | 0 | 0 | 0 |
| RICHARD BLOCK MD | |||||||||||||
| 411377 | 0 | 150 | 0 | 0 | 0 | 16831 | 0 | 17585 | 0 | 445943 | 0 | 0 | 0 |
| KENNETH KOLARSKY MD | |||||||||||||
| 364180 | 0 | 130 | 0 | 0 | 0 | 0 | 0 | 14057 | 0 | 378367 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 4b: | ReturnReference |
| Explanation | William Winter, President, participated in a supplemental nonqualified retirement plan during the tax year. The Hospital created a trust to fully secure the obligation, and its assets were subject to the claims of the Hospital's general creditors until the funds were distributed to the individual. The trust was closed during the tax year and Mr. Winter received payments from the plan in the amount of $545,159 during calendar year 2009, shown in Part II above as W-2 other compensation. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL FACILITY AUTHORITY - SILVERTONOR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 931074291 | IssuerEIN |
| Date Issued | 2006-10-26 | DateIssued |
| Issue Price | 10097600 | IssuePrice |
| Description Of Purpose | CAPITAL IMPROVEMENTS AND EQUIPMENT ACQUISITIONS | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 10097600 | TotalProceeds |
| Amount Defeased | 3966670 | AmountDefeased |
| Issuance Costs From Proceeds | 97600 | IssuanceCostsFromProceeds |
| Capital Expenditures | 6033330 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 0 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| JEFF FRITSCHE | |||
| HOSPITAL CFO/EMPLOYEE OF MANAGEMENT COMPANY PROVIDING SERVICES TO HOSPITAL | 239799 | JEFF FRITSCHE IS THE CFO OF THE HOSPITAL BY CONTRACT WITH A THIRD-PARTY MANAGEMENT COMPANY AND IS AN EMPLOYEE OF THAT MANAGEMENT COMPANY; THE MANAGEMENT COMPANY PROVIDES VARIOUS SERVICES TO THE HOSPITAL, WHICH INCLUDE THE CFO POSITION. THE TRANSACTION AMOUNT IS THE AMOUNT THE HOSPITAL PAID THE MANAGEMENT COMPANY FOR FINANCIAL SERVICES. | 0 |
| BOB ENGLE | |||
| HOSPITAL BOARD MEMBER/OWNER OF PARTNERSHIP LEASING PROPERTY TO HOSPITAL | 2176935 | Bob Engle is a greater than 5% owner of 3 partnerships, which each lease property to the hospital. The transaction amount is total lease payments paid to the 3 partnerships during the fiscal year. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 3 | THE HOSPITAL CONTRACTS WITH A THIRD-PARTY NONPROFIT CORPORATION TO PROVIDE VARIOUS MANAGEMENT SERVICES, INCLUDING FINANCIAL SERVICES (INCLUDING THE CFO POSITION), GROUP PURCHASING AND PATIENT ACCOUNTING SERVICES. |
| Form 990, Part VI, Section B, line 11 | Form 990 is presented to the finance committee for review and approval. this committee includes governing board members, and all board members are invited to attend. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy is sent out annually for officers, directors, trustees and key employees to review the policy and complete the conflict of interest statement. Any conflicts are brought to the board and handled according to the procedure stated in the conflict of interest policy. |
| Form 990, Part VI, Section B, line 15 | Legal counsel developed a process to determine compensation of the CEO, which includes comparability data and development of a compensation grid. Comparability data was used from Northwest executive compensation survey and a standard process was followed in determining compensation for key employees. |
| Form 990, Part VI, Section C, line 19 | Governing documents, conflict of interest policy and financial statements are made available to the public upon request. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-VALLEY MEDICAL MANAGEMENT COMPANY LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 342 FAIRVIEW STREET | AddressLine1 |
| City | SILVERTON | City |
| State | OR | State |
| ZIP Code | 97381 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800612509 | EIN |
| Primary Activity | MANAGEMENT OF THE CATHETERIZATION LAB AT SILVERTON HOSPITAL | PrimaryActivity |
| Legal Domicile State | OR | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | RELATED | PredominantIncomeType |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-VALLEY MEDICAL MANAGEMENT COMPANY LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionType |
| Amount Involved | 76500 | AmountInvolved |