SALEM HEALTH FOUNDATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SALEM HEALTH FOUNDATION (EIN 23-7002687)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201132279349304583
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-15T18:05:36-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1AKT LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15665 SW Meadows Rd Suite 200AddressLine1
CityLake OswegoCity
StateORState
ZIP Code97035ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237002687EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Salem Hospital FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSALENameControl
Phone5035615576Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1890 OAK STREET SEAddressLine1
CitySalemCity
StateORState
ZIP Code97301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMartin A MorrisName
TitleVP & CHIEF DEVELOPMENT OFFICERTitle
Phone5035615576Phone
Date Signed2011-08-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoylyn M Ankeney CPAName
Phone5036204489Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARTIN A MORRISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1890 OAK STREET SEAddressLine1
CitySalemCity
StateORState
ZIP Code97301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2245073GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.salemhospital.org/foundationWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1968YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionDEDICATED TO RAISING, MANAGING AND DISTRIBUTING FUNDS TO HELP SALEM HOSPITAL ACHIEVE ITS MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY IT SERVES.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers15TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1543785ContributionsGrantsPriorYear
Contributions Grants Current Year1212534ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year-53106InvestmentIncomePriorYear
Investment Income Current Year387545InvestmentIncomeCurrentYear
Other Revenue Prior Year-13359OtherRevenuePriorYear
Other Revenue Current Year51882OtherRevenueCurrentYear
Total Revenue Prior Year1477320TotalRevenuePriorYear
Total Revenue Current Year1651961TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year3114059GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1480531GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY18952TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year35088TotalFundrsngExpCurrentYear
Other Expense Prior Year415879OtherExpensePriorYear
Other Expenses Current Year323097OtherExpensesCurrentYear
Total Expenses Prior Year3529938TotalExpensesPriorYear
Total Expenses Current Year1822580TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2052618RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-170619RevenuesLessExpensesCY
Total Assets BOY9597803TotalAssetsBOY
Total Assets EOY9023685TotalAssetsEOY
Total Liabilities BOY726232TotalLiabilitiesBOY
Total Liabilities EOY82801TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8871571NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8940884NetAssetsOrFundBalancesEOY
Mission DescriptionTHE SALEM HOSPITAL FOUNDATION IS DEDICATED TO RAISING, MANAGING AND DISTRIBUTING FUNDS TO HELP SALEM HOSPITAL ACHIEVE ITS MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY IT SERVESMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense131818Expense
Grants131818Grants
DescriptionSCHOLARSHIPS: NURSING, MEDICAL SCHOOL AND OTHER HEALTHCARE PROGRAMS. RECIPIENTS OF HEALTH CARE RELATED ACADEMIC SCHOLARSHIPS AND THE AMOUNTS OF THE AWARDS ARE DETERMINED BY ANALYSES OF THE CANDIDATES' QUALIFICATIONS, SCHOLARSHIP AWARDS ALREADY AWARDED TO THEM FOR THE YEAR BY OTHER ORGANIZATIONS, AND THE COSTS OF THE SPECIFIC SCHOOLS THE VARIOUS CANDIDATES WISH TO ATTEND.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1267154Expense
Grants1267154Grants
DescriptionPROPOSALS TO FUND CAPITAL EQUIPMENT AND MEDICALLY-RELATED ACTIVITIES AT SALEM HOSPITAL ARE RECEIVED AND REVIEWED BY THE FOUNDATION'S CHIEF DEVELOPMENT OFFICER. PROPOSALS ARE FORWARDED TO THE FOUNDATION'S BOARD OF DIRECTORS FOR FURTHER REVIEW AND APPROVAL IF THEY ARE CONSIDERED TO BE CONSISTENT WITH THE FOUNDATION'S ARTICLES OF INCORPORATION, STATING THAT ITS FUNDS ARE TO BE USED FOR HEALTH CARE, CHARITABLE, AND SCIENTIFIC PURPOSES, AND FOR MEDICAL AND SCIENTIFIC EDUCATION AND RESEARCH FOR THE USE AND BENEFIT OF SALEM HOSPITAL.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense81559Expense
Grants81559Grants
DescriptionCERTAIN RESTRICTED FUNDS HAVE BEEN CREATED AND ARE USED FOR THE PURPOSE ASSISTING DIABETES AND CANCER PATIENTS WITH THE COSTS OF THEIR EDUCATIONAL, SUPPLY AND OTHER CARE-RELATED EXPENSES. IN ADDITION, FUNDS ARE DISTRIBUTED TO ASSIST LOW INCOME INDIVIDUALS MEDICAL REQUIREMENTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense1480531TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Salem HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5035611200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1890 Oak Street SEAddressLine1
CitySalemCity
StateORState
ZIP Code97301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
TIM ABRAHAMSON
CHAIR1.00XX000
KELLY YUNKER
VICE CHAIR1.00XX000
KATHY GORDON
SECRETARY/TREASURER1.00XX000
MARI BAILEY
DIRECTOR1.00X000
GARTH BRANDAW
DIRECTOR1.00X000
JAN BUFFA PHD
DIRECTOR1.00X000
PAUL GEHLAR
DIRECTOR1.00X000
JIM GRIGGS
DIRECTOR1.00X000
WILLIAM HANSEN
DIRECTOR1.00X000
MARK LYMAN
DIRECTOR1.00X000
JENNIFER NEAHRING MD
DIRECTOR1.00X000
KRIS NORTON
DIRECTOR1.00X000
BUD PIERCE MD
DIRECTOR1.00X000
JOHN ROSS MD
DIRECTOR1.00X000
JIM WASENMILLER MD
DIRECTOR1.00X000
MARTIN MORRIS
VP/CHIEF DEVELOPMENT OFFICER40.00X018237150443
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs182371TotalReportableCompFrmRltdOrgs
Total Other Compensation50443TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events3200FundraisingEvents
All Other Contributions1209334AllOtherContributions
Total Contributions1212534TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column195919TotalRevenueColumn
Exclusion$195,919ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real12054Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real628Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real11426Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column11426TotalRevenueColumn
Exclusion$11,426ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities758931Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities567305Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities191626Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column191626TotalRevenueColumn
Exclusion$191,626ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events65635GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events3200CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses25179FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column40456TotalRevenueColumn
Exclusion$40,456ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1651961TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$439,427ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1267154Total
Program Services1267154ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total213377Total
Program Services213377ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total16400Total
Management And General16400ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total18952Total
Fundraising18952Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4409Total
Management And General4409ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total5483Total
Fundraising5483Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total21652Total
Management And General10999ManagementAndGeneral
Fundraising10653Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total380Total
Management And General380ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1957Total
Management And General1957ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
MANAGEMENT SERVICES252981252981
MISCELLANEOUS1303213032
SOFTWARE/DATA PROCESS33263326
BANK FEES11701170
PROFESSIONAL DEVELOPMEN11701170

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1137Total
Management And General1137ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1822580Total
Program Services1480531ProgramServices
Management And General306961ManagementAndGeneral
Fundraising35088Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1921832BOY
EOY483294EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1410000LandBuildingsEquipmentBasis

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1410000BOY
EOY1410000EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6170859BOY
EOY7024642EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY44600BOY
EOY56026EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY50512BOY
EOY49723EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9597803BOY
EOY9023685EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3665BOY
EOY354EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY722567BOY
EOY82447EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY726232BOY
EOY82801EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4150909BOY
EOY4272145EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2517094BOY
EOY2464071EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2203568BOY
EOY2204668EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8871571BOY
EOY8940884EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9597803BOY
EOY9023685EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1951184CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1523910CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2295581CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year934781CurrentTaxYearMinus1Year
Current Tax Year1212534CurrentTaxYear
Total7917990Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1951184CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1523910CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2295581CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year934781CurrentTaxYearMinus1Year
Current Tax Year1212534CurrentTaxYear
Total7917990Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total1209210AmountsSubstContributorsTotal
Public Support Total1706708780PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years262953CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years472204CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years293281CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year70592CurrentTaxYearMinus1Year
Current Tax Year52561CurrentTaxYear
Total1151591Total
FieldValueIRS element (for citing)
Total Support9069581TotalSupport
Public Support Pertcentage1700.73970PublicSupportPertcentage170
Public Support Pertcent Prior Year0.76930PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2344770BeginningOfYearBalance
Contributions19335Contributions
Investment Earnings Or Losses167208InvestmentEarningsOrLosses
Other Expenditures35521OtherExpenditures
End Of Year Balance2495792EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2285949BeginningOfYearBalance
Contributions31343Contributions
Investment Earnings Or Losses50166InvestmentEarningsOrLosses
Other Expenditures22688OtherExpenditures
End Of Year Balance2344770EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1410000InvestmentCostOrOtherBasis
Book Value1410000BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1410000TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
LIABILITY FOR ANNUITY PAYMENTS TO DONORS$8,512
DUE TO SALEM HOSPITAL$73,935
FieldValueIRS element (for citing)
Total Of Amounts82447TotalOfAmounts
Total Revenue1651961TotalRevenue
Total Expenses1822580TotalExpenses
Excess Or Deficit For Year-170619ExcessOrDeficitForYear
Net Unrealized GL On Investments239932NetUnrealizedGLOnInvestments
Total Adjustments239932TotalAdjustments
Excess Or Deficit Per FS69313ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2330888TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments239932NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities413188DonatedSrvcAndUseOfFacilities
Other Revenues25807OtherRevenues
Revenue Not Rptd F990678927RevenueNotRptdF990
Revenue Subtotal1651961RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901651961TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2261575TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities413188DonatedServicesUseOfFacilities
Other Expenses Included25807OtherExpensesIncluded
Expenses Not Rptd F990438995ExpensesNotRptdF990
Expenses Subtotal1822580ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901822580TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:Salem Hospital Foundation holds endowment funds for the benefit of Salem Hospital and for use towards the Foundation's mission.
Part XII, Line 2d - Other Adjustments:rental expenses netted with revenue: 628. special event expenses netted with revenue: 25179.
Part XIII, Line 2d - Other Adjustments:rental expenses netted with revenue: 628. special event expenses netted with revenue: 25179.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1Advanced MarketingBusinessNameLine1
FieldValueIRS element (for citing)
ActivityDirect mail solicitationActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts40114GrossReceipts
Amount Retained By Contractor18952AmountRetainedByContractor
Net To Organization21162NetToOrganization
FieldValueIRS element (for citing)
Total Gross Receipts40114TotalGrossReceipts
Total Retained By Contractors18952TotalRetainedByContractors
Total Net To Organization21162TotalNetToOrganization

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event168835GrossReceiptsEvent1
Charitable Contributions Event13200CharitableContributionsEvent1
Gross Revenue Event165635GrossRevenueEvent1
Cash Prizes Event1340CashPrizesEvent1
Non Cash Prizes Event16462NonCashPrizesEvent1
Rent Facility Costs Event115600RentFacilityCostsEvent1
Food And Beverage Event1914FoodAndBeverageEvent1
Other Direct Expenses Event11863OtherDirectExpensesEvent1
Gross Receipts Total68835GrossReceiptsTotal
Charitable Contributions Total3200CharitableContributionsTotal
Gross Revenue Total Events65635GrossRevenueTotalEvents
Cash Prizes Total Events340CashPrizesTotalEvents
Non Cash Prizes Total Events6462NonCashPrizesTotalEvents
Rent Facility Costs Total Events15600RentFacilityCostsTotalEvents
Food And Beverage Total Events914FoodAndBeverageTotalEvents
Other Direct Expenses Total Events1863OtherDirectExpensesTotalEvents
Direct Expense Summary Events25179DirectExpenseSummaryEvents
Net Income Summary40456NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1SALEM HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1890 OAK STREET SEAddressLine1
CitySALEMCity
StateORState
ZIP Code97301ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient930579722EINOfRecipient
IRC Section503(c)(3)IRCSection
Amount Of Cash Grant1267154AmountOfCashGrant
Method Of Valuationn/aMethodOfValuation
Description Of Non Cash Assistancen/aDescriptionOfNonCashAssistance
Purpose Of GrantTO PAY FOR GENERAL EXPENSES AND CAPITAL EXPENDITURES.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistanceAmount Of Non Cash AssistanceAmountOfNonCashAssistance
SCHOLARSHIPS TO COLLEGE STUDENTS82131818N/ASCHOLARSHIPS PAID DIRECTLY TO COLLEGES FOR STUDENTS WHO ARE PURSUING A CAREER IN HEALTHCARE. MUST HAVE A PERMANENT RESIDENCE IN MARION, POLK, OR YAMHILL COUNTY AND BE ACCEPTED AT LEAST 1/2 TIME TO FORMAL PROGRAM.
SMALL EMERGENCY CASH GRANTS($150-$300/MAX) TO INDIGENT PATIENTS10628081N/AGRANTS GIVEN TO PATIENTS TO MEET EMERGENCY NEEDS SUCH AS MEDICATION, UTILITIES, TRANSPORTATION, RENT, ETC. (NO INDIVIDUAL GRANT EXCEEDS $300)
NON-CASH SUPPORT OF INDIGENT PATIENTS OF SALEM HOSPITAL AND/OR COMMUNITY MEMBERS897ACTUAL COSTMEDICATIONS, TRANSPORTATION, DURABLE MEDICAL EQUIPMENT, NON-MEDICAL SAFETY/PREVENTION ITEMS (CAR SEATS, EMERGENCY CALL SYSTEM, ETC), REQUIRED HEALTH COUNSELING, EDUCATION.53478

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: Decisions on grants to Salem Hospital are made by the Salem Hospital Foundation Board of Directors. Minutes of the meetings of the Foundation board are shared with the Salem Health Board of Trustees each month. Scholarships are granted to college students that reside in Marion, Polk or Yamhill counties and are pursuing a healthcare related career. A scholarship committee reviews individual applications and recommends to the Board recipient awards for approval. Scholarships awarded are paid directly to the educational institutions for tuition or related costs.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARTIN MORRISBusinessNameLine1
FieldValueIRS element (for citing)
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs179249CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs3122OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs26363DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs24080NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs232814TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart IIIReturnReference
ExplanationCompensation of the V.P. & Chief Development Officer is determined by the CEO of Salem Health, in conjunction with other salary survey or public information and independent consultants to ensure the compensation is competitive in the market for similar positions at comparable organizations.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11THE ORGANIZATION'S GOVERNING EXECUTIVE COMMITTEE REVIEWS THE IRS FORM 990 BEFORE FILING.
Form 990, Part VI, Section B, line 12cOn an annual basis the Secretary shall send to each person who is a trustee, officer, or member of a committee a copy of the Policy regarding Conflicts of Interest, together with a questionnaire inquiring as to conflicts, to be completed and returned to the Secretary by the trustee, officer or committee member prior to the beginning of each calendar year.
Form 990, Part VI, Section C, line 19NO DOCUMENTS AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HAMPSHIRE PROPERTIES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1890 OAK STREET SEAddressLine1
CitySALEMCity
StateORState
ZIP Code97301ZIPCode
FieldValueIRS element (for citing)
EIN870804582EIN
Primary ActivitiesREAL ESTATE HOLDINGPrimaryActivities
Legal Domicile StateORLegalDomicileState
Total Income12054TotalIncome
EOY Assets1410000EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
SALEM HOSPITAL
890 OAK STREET SESALEMOR97301930579722HOSPITALOR501(c)(3)3Salem Health
SALEM HOSPITAL AUXILIARY
890 OAK STREET SESALEMOR97301931081113SUPPORTS SALEM HOSPITALOR501(c)(3)9N/A
SALEM HEALTH
890 OAK STREET SESALEMOR97301930823471LEASES LAND TO SALEM HOSPITALOR501(c)(3)11 Type 1N/A
WEST VALLEY HOSPITAL
525 SOUTHEAST WASHINGTON STREETDALLASOR97338431960221HOSPITALOR501(c)(3)3Salem Health
WEST VALLEY HOSPITAL FOUNDATION
525 SOUTHEAST WASHINGTON STREETDALLASOR97338931298564SUPPORTS WEST VALLEY HOSPITALOR501(c)(3)11 Type 1Salem Health
WILLAMETTE VALLEY INSURANCE COMPANY
745 FORT STREETHONOLULUHI96813201836190CAPTIVE INSURANCEHI501(c)(3)11 Type 1Salem Health
WILLAMETTE VALLEY PROFESSIONAL SERVICES
890 OAK STREET SESALEMOR97301753175249BILLING SERVICE FOR SALEM HOSPITAL, WEST VALLEY HOSPITAL, & SALEM HEALTHOR501(c)(3)3salem Health
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
SALEM HOSPITAL
B1267154
SALEM HOSPITAL
E73935

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