MID-COLUMBIA MEDICAL CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MID-COLUMBIA MEDICAL CENTER (EIN 93-0386936)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201143199349309514
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T17:11:25-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAP LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4500 SW KRUSE WAY NO 200 | AddressLine1 |
| City | LAKE OSWEGO | City |
| State | OR | State |
| ZIP Code | 97035 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930386936 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MID- | NameControl |
| Phone | 5412961111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH STREET | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DUANE FRANCIS | Name |
| Title | CEO | Title |
| Phone | 5412961111 | Phone |
| Date Signed | 2011-11-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WESLEY B HANSEN | Name |
| Phone | 5036974118 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DUANE FRANCIS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH STREET | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 100371365 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MCMC.NET | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE; TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLYMET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1020 | TotalNbrEmployees |
| Total Nbr Volunteers | 220 | TotalNbrVolunteers |
| Total Gross UBI | 34539 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 418710 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2268291 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 91642854 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 95355581 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 118095 | InvestmentIncomePriorYear |
| Investment Income Current Year | 136811 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1030475 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2610682 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 93210134 | TotalRevenuePriorYear |
| Total Revenue Current Year | 100371365 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 509950 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 31064 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 50110639 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 55131286 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 38655819 | OtherExpensePriorYear |
| Other Expenses Current Year | 43088780 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 89276408 | TotalExpensesPriorYear |
| Total Expenses Current Year | 98251130 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3933726 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2120235 | RevenuesLessExpensesCY |
| Total Assets BOY | 46344289 | TotalAssetsBOY |
| Total Assets EOY | 48079159 | TotalAssetsEOY |
| Total Liabilities BOY | 20980400 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 20916759 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 25363889 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 27162400 | NetAssetsOrFundBalancesEOY |
| Mission Description | ACUTE CARE HOSPITAL - SEE SCH O | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 90572518 | Expense |
| Grants | 31064 | Grants |
| Revenue | 97016419 | Revenue |
| Description | ACUTE HOSPITAL CARE: INPATIENT DAYS 7,147, INPATIENT REHAB DAYS 1,215, OUTPATIENT OBSERVATION DAYS 1,764, LABORATORY TESTS 197,898, IMAGING TESTS 28,587, HOME HEALTH EPISODES 1,273, EMERGENCY VISITS 16,697, VISITING PHYSICIAN VISITS 3,114, MEDICAL ONCOLOGY 10,501, OUTPATIENT SURGERIES 2,302, RADIATION ONCOLOGY OUTPATIENT PROCEDURES 9,296, TOTAL OUTPATIENTS 129,391.SEE SCHEDULE H FOR NARRATIVE OF PROGRAM SERVICE ACCOMPLISHMENTS. | Description |
| Total Program Service Expense | 90572518 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 145 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 1020 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | 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 | 1 | 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 | MID-COLUMBIA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5412961111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 E 19TH STREET | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| CARINA SCHMIDT | ||||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | |||
| GRETCHEN KIMSEY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DAN BOLDT | ||||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | |||
| ROBERT L R BAILEY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| WALLACE WOLF JR DVM | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | |||
| PAUL CARDOSI | ||||||||
| DIRECTOR | 50.00 | X | 200657 | 0 | 24815 | X | ||
| DUANE FRANCIS | ||||||||
| CEO | 50.00 | 0 | 454040 | 123877 | X | |||
| DONALD ARBON | ||||||||
| CFO | 50.00 | 0 | 215951 | 25699 | X | |||
| REGINA ROSE | ||||||||
| VP - CHIEF NURSING OFFICER | 50.00 | 158683 | 0 | 22459 | X | |||
| WILLIAM HAMILTON | ||||||||
| VP - MEDICAL AFFAIRS | 50.00 | 292971 | 0 | 23928 | X | |||
| XINYU FU | ||||||||
| PHYSICIAN | 50.00 | 370050 | 0 | 27439 | X | |||
| THOMAS NICHOL | ||||||||
| PHYSICIAN | 50.00 | 231608 | 0 | 26779 | X | |||
| SAMUEL TAYLOR | ||||||||
| PHYSICIAN | 50.00 | 225230 | 0 | 26469 | X | |||
| BRIAN MACARTHUR | ||||||||
| PHYSICIAN | 50.00 | 225660 | 0 | 13528 | X | |||
| GARY GINGRICH | ||||||||
| PHYSICIAN | 50.00 | 217113 | 0 | 17514 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1921972 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 669991 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 332507 | TotalOtherCompensation |
| Number Individuals GT100 K | 63 | 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 |
|---|---|---|---|---|---|
| COLUMBIA GORGE PATHOLOGY ASSN | |||||
| 1700 E 19TH ST | THE DALLES | OR | 97058 | PATHOLOGY | 991165 |
| RADIATION ONCOLOGISTS PC | |||||
| 1400 NW IRVING ST SUITE 527 | PORTLAND | OR | 97209 | MEDICAL SERVICES | 818045 |
| PATRICK GRIMSLEY | |||||
| 1700 E 19TH ST | THE DALLES | OR | 97058 | EMERGENCY ROOM PHYSICIAN | 352616 |
| JOHN ELLIOT MD | |||||
| 1700 E 19TH ST | THE DALLES | OR | 97058 | MEDICAL SERVICES | 328284 |
| MID-COLUMBIA SURGICAL SPECIALISTS | |||||
| 1810 E 19TH ST SUITE 225 | THE DALLES | OR | 97058 | MEDICAL SERVICES | 313700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Related Organizations | 793736 | RelatedOrganizations |
| Government Grants | 19898 | GovernmentGrants |
| All Other Contributions | 1454657 | AllOtherContributions |
| Total Contributions | 2268291 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE/MEDICAID PMNT | 900099 | 102098363 | 102098363 |
| HOSPITAL REVENUE | 900099 | 75598115 | 75598115 |
| CLINIC REVENUE | 900099 | 9167140 | 9167140 |
| LESS:CONTRACTUALS-HOSP | 900099 | -91508037 | -91508037 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 95355581 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 61811 | TotalRevenueColumn |
| Exclusion | $61,811 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 62006 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 62006 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 62006 | TotalRevenueColumn |
| Exclusion | $62,006 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 75000 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 75000 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 75000 | TotalRevenueColumn |
| Exclusion | $75,000 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| DAYCARE | 624410 | 438578 | $438,578 | |
| CAFETERIA | 722100 | 414721 | $414,721 | |
| LAUNDRY | 812300 | 34539 | 34539 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1660838 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1660838 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2548676 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 100371365 | TotalRevenueColumn |
| Related Or Exempt Function Income | 97016419 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 34539 | UnrelatedBusinessRevenue |
| Exclusion | $1,052,116 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31064 | Total |
| Program Services | 31064 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 723513 | Total |
| Management And General | 723513 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42745660 | Total |
| Program Services | 40925424 | ProgramServices |
| Management And General | 1820236 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2235043 | Total |
| Program Services | 2095535 | ProgramServices |
| Management And General | 139508 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6374848 | Total |
| Program Services | 5976941 | ProgramServices |
| Management And General | 397907 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3052222 | Total |
| Program Services | 2861707 | ProgramServices |
| Management And General | 190515 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1080000 | Total |
| Management And General | 1080000 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160350 | Total |
| Management And General | 160350 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131954 | Total |
| Management And General | 131954 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3360643 | Total |
| Program Services | 3238839 | ProgramServices |
| Management And General | 121804 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 687657 | Total |
| Program Services | 633155 | ProgramServices |
| Management And General | 54502 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 437199 | Total |
| Program Services | 437199 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2832786 | Total |
| Program Services | 2744694 | ProgramServices |
| Management And General | 88092 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1035274 | Total |
| Program Services | 981290 | ProgramServices |
| Management And General | 53984 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 13260430 | 13198822 | 61608 |
| PURCHASED SERVICES | 5531638 | 3289669 | 2241969 |
| MEDICAL PROF. FEES | 5349573 | 5349573 | |
| BAD DEBT EXPENSE | 5280820 | 5276590 | 4230 |
| UTILITIES | 1113260 | 1081857 | 31403 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2827196 | Total |
| Program Services | 2450159 | ProgramServices |
| Management And General | 377037 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98251130 | Total |
| Program Services | 90572518 | ProgramServices |
| Management And General | 7678612 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 4889659 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1327131 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11504355 | BOY |
| EOY | 12527756 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1585612 | BOY |
| EOY | 1828326 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1877802 | BOY |
| EOY | 1444501 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 55600695 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 39039781 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15398925 | BOY |
| EOY | 16560914 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14650464 | BOY |
| EOY | 10828003 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46344289 | BOY |
| EOY | 48079159 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7891915 | BOY |
| EOY | 8344130 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10409559 | BOY |
| EOY | 9967074 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2678926 | BOY |
| EOY | 2605555 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20980400 | BOY |
| EOY | 20916759 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24638654 | BOY |
| EOY | 26792269 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 725235 | BOY |
| EOY | 370131 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25363889 | BOY |
| EOY | 27162400 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46344289 | BOY |
| EOY | 48079159 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2120235 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -321724 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 357664 | BeginningOfYearBalance |
| Contributions | 32657 | Contributions |
| Investment Earnings Or Losses | 402 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 23127 | GrantsOrScholarships |
| End Of Year Balance | 367596 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 358543 | BeginningOfYearBalance |
| Contributions | 13818 | Contributions |
| Investment Earnings Or Losses | 890 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 15587 | GrantsOrScholarships |
| End Of Year Balance | 357664 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 347617 | BeginningOfYearBalance |
| Contributions | 10659 | Contributions |
| Investment Earnings Or Losses | 6106 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 5839 | GrantsOrScholarships |
| End Of Year Balance | 358543 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.98010 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.01990 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 212933 | OtherCostOrOtherBasis |
| Book Value | 212933 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13839188 | OtherCostOrOtherBasis |
| Depreciation | 7757877 | Depreciation |
| Book Value | 6081311 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 40587408 | OtherCostOrOtherBasis |
| Depreciation | 30577485 | Depreciation |
| Book Value | 10009923 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 961166 | OtherCostOrOtherBasis |
| Depreciation | 704419 | Depreciation |
| Book Value | 256747 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16560914 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (9 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER ASSETS | 2571182 |
| BOARD DESIGNATED ASSETS - CASH & MONEY MARKET | 5202757 |
| BOARD DESIGNATED ASSETS - CERTIFICATES OF DEPOSIT | 571059 |
| BOARD DESIGNATED ASSETS - MUTUAL FUNDS | 1518210 |
| BOARD DESIGNATED ASSETS - CORPORATE BONDS | 50000 |
| BOARD DESIGNATED ASSETS - ACCRUED INTEREST RECEIVABLE | 3401 |
| INTEREST IN NET ASSETS OF MC FOUNDATION | 370131 |
| BOARD DESIGNATED ASSETS - CURRENT PORTION | 120389 |
| DUE FROM AFFILIATE | 420874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 10828003 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASES | $1,269,046 |
| OTHER LIABILITIES | $517,000 |
| SETTLEMENT RESERVES | $819,509 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2605555 | TotalOfAmounts |
| Total Revenue | 100371365 | TotalRevenue |
| Total Expenses | 98251130 | TotalExpenses |
| Excess Or Deficit For Year | 2120235 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 9004 | NetUnrealizedGLOnInvestments |
| Other | -$330,728 | OtherAmount |
| Total Adjustments | -321724 | TotalAdjustments |
| Excess Or Deficit Per FS | 1798511 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 100380369 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 9004 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 9004 | RevenueNotRptdF990 |
| Revenue Subtotal | 100371365 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 100371365 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 98226754 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 98226754 | ExpensesSubtotal |
| Other Expenses Not Included | 24376 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 24376 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 98251130 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | DECREASE IN INTEREST IN NET ASSETS OF MID-COLUMBIA HEALTH FOUNDATION -355,104. WRITE-OFF PAYABLE TO AFFILIATE - NET 24,376. |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | WRITE-OFF PAYABLE DUE TO (RECEIVABLE DUE FROM) AFFILIATE - NET 24,376. |
| PART X, LINE 2 - FIN 48 FOOTNOTE DISCLOSURE FOR UNCERTAIN TAX POSITIONS: INCOME TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AT THE LARGEST AMOUNT OF INCOME TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH INCOME TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED INCOME TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS WOULD BE CLASSIFIED AS INCOME TAXES IN THE STATEMENTS OF OPERATIONS. THERE WERE NO UNRECOGNIZED INCOME TAX BENEFITS, NOR ANY INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED INCOME TAX BENEFITS, ACCRUED OR EXPENSED AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2010 AND 2009. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Tailored To Ind Hospitals | X | PolicyTailoredToIndHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3722000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3722000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03790 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10049037 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6192107 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3856930 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03930 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13771037 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6192107 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7578930 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07720 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 737844 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 27527 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 710317 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00720 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 315274 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 312274 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 485977 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 485977 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00490 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 153545 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 153545 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1692640 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30527 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1662113 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01690 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15463677 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6222634 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9241043 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09410 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 3435 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3435 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1714 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1714 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 214075 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 214075 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1719 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1719 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 220943 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 220943 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,620,383 | BadDebtExpenseAmount |
| Amount Attributable To | 36974 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 20098623 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 23322893 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3224270 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 5 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (5 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| MID-COLUMBIA MEDICAL CENTER | ||||||||
| 1 | 1700 E 19TH STREET | THE DALLES | OR | 97058 | X | X | X | |
| COLUMBIA HILLS FAMILY MEDICINE | ||||||||
| 2 | 1620 E 12TH STREET | THE DALLES | OR | 97058 | RURAL HEALTH CLINIC | |||
| DR ALAIMO | ||||||||
| 3 | 1726 E 12TH STREET | THE DALLES | OR | 97058 | RURAL HEALTH CLINIC | |||
| WATER'S EDGE CLINICS | ||||||||
| 4 | 551 LONE PINE BLVD | THE DALLES | OR | 97058 | RURAL HEALTH CLINIC | |||
| INTERNAL MEDICINE CLINIC - RHC | ||||||||
| 5 | 1810 1815 1825 E 19TH STREET | THE DALLES | OR | 97058 | RURAL HEALTH CLINIC | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (5 entries)
| Hospital Facility NumberHospitalFacilityNumber | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | FPG Free PercentFPGFreePercent | Uses FPG DiscountedUsesFPGDiscounted | FPG Discount PercentFPGDiscountPercent | Explains BasisExplainsBasis | Income LevelIncomeLevel | Uninsured DiscountUninsuredDiscount | Medicaid MedicareMedicaidMedicare | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Posted On WebsitePostedOnWebsite | Posted In Emergency RoomPostedInEmergencyRoom | Posted In Admission OfficePostedInAdmissionOffice | Provided On AdmissionProvidedOnAdmission | Available On RequestAvailableOnRequest | Other PublicityOtherPublicity | Actions On NonpaymentActionsOnNonpayment | Permit Other ActionsPermitOtherActions | Collection ActivitiesCollectionActivities | Report To Credit AgencyReportToCreditAgency | LawsuitLawsuit | Other ActionsOtherActions | Notify Upon AdmissionNotifyUponAdmission | Notified All PatientsNotifiedAllPatients | Documented DeterminationDocumentedDetermination | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Used Other MethodUsedOtherMethod | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MID-COLUMBIA MEDICAL CENTER | ||||||||||||||||||||||||||||||
| 1 | 1 | 1 | 150.000000000000 | 1 | 150.000000000000 | 1 | X | X | X | 1 | 1 | X | X | X | X | X | X | 1 | X | 1 | X | X | X | X | X | X | 1 | X | 0 | 0 |
| COLUMBIA HILLS FAMILY MEDICINE - RHC | ||||||||||||||||||||||||||||||
| 2 | 1 | 1 | 150.000000000000 | 1 | 150.000000000000 | 1 | X | X | X | 1 | 1 | X | X | 0 | 1 | X | X | X | X | 1 | X | 0 | 0 | |||||||
| DR ALAIMO | ||||||||||||||||||||||||||||||
| 3 | 1 | 1 | 150.000000000000 | 1 | 150.000000000000 | 1 | X | X | X | 1 | 1 | X | X | 0 | 1 | X | X | X | X | 1 | X | 0 | 0 | |||||||
| WATER'S EDGE CLINICS | ||||||||||||||||||||||||||||||
| 4 | 1 | 1 | 150.000000000000 | 1 | 150.000000000000 | 1 | X | X | X | 1 | 1 | X | X | 0 | 1 | X | X | X | X | 1 | X | 0 | 0 | |||||||
| INTERNAL MEDICINE CLINIC - RHC | ||||||||||||||||||||||||||||||
| 5 | 1 | 1 | 150.000000000000 | 1 | 150.000000000000 | 1 | X | X | X | 1 | 1 | X | X | 0 | 1 | X | X | X | X | 1 | X | 0 | 0 | |||||||
Form990 Schedule H Part VI Form990ScheduleHPartVI (23 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: TRACK DIRECT LABOR AND OTHER COSTS IN EACH CATEGORY FOR ALL PATIENT SEGMENTS. IF ONLY REVENUE INFORMATION WAS AVAILABLE, A COST/CHARGE RATIO WAS APPLIED TO ESTIMATE COSTS. | ||
| PART I, LINE 7G: NUMBERS INCLUDE 2 PROVIDER-BASED RHC PHYSICIAN CLINICS AND ONE LANGUAGE INTERPRETIVE COST CENTER (WE FOLLOW THE CMS GUIDELINES FOR % OF INTERPRETIVE SERVICES REQUIRED TO BE PROVIDED FOR FREE - REPORTED NET EXPENSE IS LESS THAT PORTION); RHC LOSSES DO NOT INCLUDE BAD DEBT OR CHARITY CARE ALREADY REPORTED IN I-7A OR III-A.2.$2,058,346 REVENUES$2,544,323 OPERATING EXPENSES$485,977 NET LOSSCOMMUNITY BENEFIT: AREA HAS A SHORTAGE OF PRIMARY CARE PHYSICIANS | ||
| PART II: PROMOTES THE HEALTH OF THE COMMUNITIES WE SERVE BY PARTICIPATING IN REGIONAL EMERGENCY PREPAREDNESS PROGRAMS (H1N1, PANDEMIC, NATURAL DISASTERS) AND DRILLS; BY SERVING AS AN ADVOCATE FOR THE COMMUNITY WITH REGARD TO LOCAL, REGIONAL AND STATE-WIDE HEALTH INITIATIVES; ACTING IN ADVISORY CAPACITY WITH OTHER LOCAL AND REGIONAL GROUPS IN ORDER TO CREATE, ACCESS AND PROVIDE SERVICES OTHERWISE NOT AVAILABLE TO THE COMMUNITY. | ||
| PART III, LINE 4: FOOTNOTE 1 IN THE AUDITED FINANCIAL STATEMENTS DESCRIBES ALLOWANCE FOR BAD DEBT EXPENSE AT GROSS CHARGE. THE ESTIMATE IS BASED PRIMARILY UPON THE MEDICAL CENTER'S HISTORICAL COLLECTION EXPERIENCE, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY, AND THE EFFECTIVENESS OF COLLECTIONS EFFORTS.BAD DEBT COST IS CALCULATED BY APPLYING THE HOSPITAL'S COST TO CHARGE RATIO. | ||
| PART III, LINE 8: MID-COLUMBIA MEDICAL CENTER CONTINUES TO PROVIDE CLINICAL SERVICES TO MEDICARE PATIENTS AT A DEFICIT AS PART OF OUR COMMITMENT TO THE RESIDENTS OF OUR COMMUNITY. THIS DEFICIT IS CONSISTENT WITH OUR TAX-EXEMPT STATUS AND MISSION TO PROVIDE COMMUNITY BASED HEALTHCARE REGARDLESS OF THE ABILITY TO PAY. | ||
| PART III, LINE 9B: IN CASES WHERE PATIENT HAS QUALIFIED FOR FULL OR PARTIAL CHARITY CARE, THAT AMOUNT IS WRITTEN DOWN IN THE PATIENT ACCOUNT AND NO ATTEMPT IS MADE TO COLLECT THE AMOUNT WRITTEN DOWN. | ||
| PART V, SECTION B, LINE 13G: CHARGES ARE SHOWN ON THE OREGON PRICE POINT WEBSITE. | MID-COLUMBIA MEDICAL CENTER | |
| PART V, SECTION B, LINE 13G: POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. | COLUMBIA HILLS FAMILY MEDICINE - RHC | |
| PART V, SECTION B, LINE 13G: POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. | DR. ALAIMO | |
| PART V, SECTION B, LINE 13G: POLICY IS DISCUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. | WATER'S EDGE CLINICS | |
| PART V, SECTION B, LINE 13G: POLICY IS DICUSSED WITH PATIENTS WHEN THEY BRING UP FINANCIAL NEED. | INTERNAL MEDICINE CLINIC - RHC | |
| PART V, SECTION B, LINE 15E: REPORT ONLY TO THIRD PARTY COLLECTION AGENCY: ASSET RECOVERY | MID-COLUMBIA MEDICAL CENTER | |
| PART V, SECTION B, LINE 16E: INSURANCE LIENS FOR MEDICAL ON ACCIDENTS. | MID-COLUMBIA MEDICAL CENTER | |
| PART V, SECTION B, LINE 19D: DISCOUNTS OF 10% TO 20% ARE OFFERED TO THE SELF-PAY PORTION ON ANY HOSPITAL BILL. A TIMELY PAYMENT DISCOUNT IS OFFERED IN ADDITION TO THE ABOVE FOR SHORT-TERM PAYMENT PLANS. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED. | MID-COLUMBIA MEDICAL CENTER | |
| PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED. | COLUMBIA HILLS FAMILY MEDICINE - RHC | |
| PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED. | DR. ALAIMO | |
| PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED. | WATER'S EDGE CLINICS | |
| PART V, SECTION B, LINE 19D: A 20% SELF-PAY DISOUNT IS OFFERED FOR FULL PAYMENT AT TIME OF SERVICE. A 15% SELF-PAY DISCOUNT IS OFFERED FOR FULL PAYMENT WHEN BILLED. OTHER DISCOUNTS MAY BE AVAILABLE DEPENDING ON FINANCIAL NEED. | INTERNAL MEDICINE CLINIC - RHC | |
| PART VI, LINE 2: MID-COLUMBIA MEDICAL CENTER HAS STRONG INSTITUTIONAL READINESS AND SUPPORT FOR COMMUNITY INITIATIVES. BOARD AND SENIOR EXECUTIVE LEADERSHIP ARE ACTIVELY INVOLVED IN PRIORITIZATION OF COMMUNITY INITIATIVES. A FULL-TIME DIRECTOR OVERSEES PROJECT DEVELOPMENT AND IMPLEMENTATION OF INSTITUTIONAL PROGRAMS AND ACTS AS THE PRIMARY LIAISON IN COMMUNITY COLLABORATIONS. MID-COLUMBIA MEDICAL CENTER HAS A FORMAL COMMUNITY BENEFIT POLICY, AND INTEGRATES INITIATIVES WITH THE OVERALL STRATEGIC PLAN.ASSESSMENT OF COMMUNITY HEALTH NEEDS AND ISSUES IS A PROGRESSIVE ACTIVITY, UTILIZING QUANTITATIVE AND QUALITATIVE DATA. THIS INFORMATION IS USED TO IDENTIFY PRIORITY FOCUS AREAS OF IMPORTANCE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITY. CHRONIC ILLNESS, ACCESS TO CARE, LIFESTYLE CHOICES AND RISKY BEHAVIORS ARE MOST FREQUENTLY OUR AREAS OF FOCUS. WE HAVE FORMED STRONG COMMUNITY PARTNERSHIPS REPRESENTATIVE OF INDIVIDUALS, GROUPS AND ORGANIZATIONS THAT HAVE AN INTEREST IN HEALTH OUTCOMES, HAVE ACCESS TO RESOURCES OR CAN ACT TO IMPROVE COMMUNITY HEALTH. THESE PARTNERSHIPS CREATE THE OPPORTUNITY FOR SYNERGISTIC UTILIZATION OF LIMITED RESOURCES. | ||
| PART VI, LINE 3: ALL FAMILY PRACTICE STAFF ACTIVELY PROMOTE HEALTHY KIDS OPTIONS, WHICH PROVIDES INSURANCE FOR ALL CHILDREN IN THE STATE OF OREGON. BROCHURES ARE AVAILABLE IN BOTH LANGUAGES AT ALL FP OFFICES AND THE SCHOOL HEALTH NURSES PROVIDE THAT INFORMATION TO THE LOCAL SCHOOLS AS WELL.OUR PATIENT AND VISITOR SERVICES AND PATIENT ACCOUNTS DEPARTMENTS TAKE AN ACTIVE ROLE IN ASSISTING PATIENTS WITH COMPLETING APPLICATIONS FOR THE OREGON HEALTH PLAN. BROCHURES (ENGLISH AND SPANISH) ARE AVAILABLE AT REGISTRATION AND IN PATIENT ACCOUNTS. THIS BROCHURE OUTLINES THE PROCESS AND PROVIDES PHONE NUMBERS AND CONTACT INFORMATION.PATIENT STATEMENTS IN BOTH ENGLISH AND SPANISH HAVE INFORMATION REGARDING FINANCIAL ASSISTANCE. CONTACT INFORMATION IS PROVIDED TO SET UP PAYMENT ARRANGEMENTS AND DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. PATIENT STATEMENTS ARE SENT OUT WEEKLY AND THERE IS A NOTE ON EACH STATEMENT WITH PHONE NUMBERS AND CONTACT INFORMATION TO SET UP PAYMENT ARRANGEMENTS AND DISCUSS PATIENT ACCOUNTS. IF THE PATIENT CALLS, AN ACCOUNT REPRESENTATIVE WORKS WITH THEM TO ASCERTAIN IF THEY QUALIFY FOR FINANCIAL ASSISTANCE. IF IT IS DETERMINED THE PATIENT MAY BE ELIGIBLE FOR ASSISTANCE, AN APPLICATION AND INSTRUCTIONS ARE SENT TO THE PATIENT. IF THE PATIENT REQUIRES ASSISTANCE IN COMPLETING THE APPLICATION AN ACCOUNT REPRESENTATIVE IS AVAILABLE TO ASSIST WITH THE PROCESS. | ||
| PART VI, LINE 4: MID-COLUMBIA MEDICAL CENTER (MCMC) IS LOCATED IN THE DALLES, WASCO COUNTY, OREGON, POPULATION 24,149. MCMC SERVES A WIDE GEOGRAPHIC AREA OF RURAL NORTH CENTRAL OREGON ALONG THE COLUMBIA RIVER WHICH SERVES AS THE DIVISION BETWEEN THE STATES OF WASHINGTON AND OREGON. THIS SERVICE AREA INCLUDES WASCO, SHERMAN AND GILLIAM COUNTIES IN OREGON AND KLICKITAT COUNTY IN WASHINGTON STATE. THE TOTAL POPULATION OF THIS SERVICE AREA, UTILIZING 2010 CENSUS DATA, IS 49,167; WHITE 91%, HISPANIC/LATINO 13.2%, AMERICAN INDIAN/ALASKA NATIVE 4.3%, OTHER 1.6%. MEDIAN HOUSEHOLD INCOME BY COUNTY IS; WASCO $40,844, GILLIAM $46,018, SHERMAN $47,473 AND KLICKITAT $41,191. 17% OF THE POPULATION WAS BELOW THE POVERTY LEVEL, 23% OF ADULTS UNDER 65 ARE UNINSURED.IN ADDITION TO THE YEAR ROUND POPULATION, THE DALLES EXPERIENCES AN INFLUX OF OVER 15,000 SEASONAL WORKERS IN SUPPORT OF THE HARVEST OF OUR AGRICULTURAL ECONOMY. | ||
| PART VI, LINE 6: MID-COLUMBIA MEDICAL CENTER IS A MISSION-DRIVEN ORGANIZATION WHOSE PURPOSE IS: TO LEAD AND ACT AS A CATALYST IN PROMOTING HEALTH FOR ALL PEOPLE;TO RECOGNIZE THE INDIVIDUAL AS A WHOLE HUMAN BEING WITH DIFFERENT NEEDS THAT MUST BE ENTHUSIASTICALLY MET;TO COMMUNICATE A VISION OF HEALTH, ART, EDUCATION, TECHNOLOGY AND A CENTER FOR HEALING WHICH WILL CONTINUALLY UPGRADE THE QUALITY OF LIFE IN THE COMMUNITY ENVIRONMENT IN WHICH WE ALL LIVE;TO EMPOWER PEOPLE TO BECOME PARTNERS IN THEIR HEALTH CARE.GUIDED BY THIS MISSION MCMC CONTINUES TO BE A SIGNIFICANT PARTNER CONTRIBUTING TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES.PREVENTION AND EDUCATIONTHOSE SEEKING HELP IN THEIR ATTEMPTS TO TAKE CONTROL OF THEIR OWN HEALTH HAD A RELIABLE PARTNER IN MCMC, WHICH ONCE AGAIN IN 2010 PROVIDED A MYRIAD OF PREVENTIVE HEALTH OPPORTUNITIES. THE CENTER FOR MIND AND BODY MEDICINE PARTNERED WITH LA NUESTRA COMUNIDAD SANA TO PROVIDE EXPERT INSTRUCTORS FOR A FAMILY WEIGHT LOSS PROGRAM. 23 FAMILIES PARTICIPATED AND GRADUATED FROM THIS BENCHMARK PROGRAM ADDRESSING NUTRITION AND OBESITY IN THE HISPANIC/LATINO POPULATION, WITH SCHOLARSHIPS PROVIDED TO PARTICIPANTS UNABLE TO COVER THE EXPENSE OF THE PROGRAM.MORE THAN 100 BLOOD PRESSURE CHECKS AND AN ARRAY OF OTHER SCREENINGS WERE PERFORMED AT THE 2010 HEALTH AND SAFETY FAIR. APPROXIMATELY 350 RESIDENTS RECEIVED FREE SCREENINGS AT THE MCMC-SPONSORED DIABETES DISCOVERY DAY.WORKING IN PARTNERSHIP WITH WASCO/SHERMAN PUBLIC HEALTH AND COLUMBIA GORGE COMMUNITY COLLEGE NURSING PROGRAM, MCMC VOLUNTEERS DONATED TIME AND PAID THEIR OWN TRAVEL EXPENSES IN ORDER TO PROVIDE FLU SHOTS TO RESIDENTS OF MAUPIN AND TYGH VALLEY.MORE THAN 200 INDIVIDUALS ATTENDED PLANETREE HEALTH RESOURCE CENTERS (PHRC) POPULAR FREE LECTURE SERIES AND AN ADDITIONAL 6,300 RESIDENTS VISITED THE CENTER IN DOWNTOWN THE DALLES TO TAKE ADVANTAGE OF ITS VAST COLLECTION OF CONSUMER HEALTH INFORMATION.PLANETREE HEALTH RESOURCE CENTER STAFF ALSO WAS INVOLVED IN SCREENING AND EDUCATION ACTIVITIES AT AN ARRAY OF COMMUNITY EVENTS INCLUDING GO RED FOR WOMEN, THE SENIOR HEALTH FAIR AND NATIONAL DEPRESSION SCREENING DAY.MEANINGFUL CONTRIBUTIONS IN THE YEAR 2010OVER 4,100 HOURS OF FREE INTERPRETATION SERVICES WERE PROVIDED TO ASSIST PATIENTS SEEKING CARE THROUGHOUT OUR ORGANIZATION (AS REQUIRED BY MEDICARE) AND TO ANY OTHER LOCAL HEALTH SERVICE PROVIDER, REGARDLESS OF AFFILIATION WITH MCMC.SUBSIDY OF THE FAMILIES FIRST HOME VISITING PROGRAM, WHICH PROVIDES INTENSIVE PARENTING SUPPORT FOR FAMILIES AT RISK FOR CHILD ABUSE PROVIDED FUNDS FOR AN ADDITIONAL FTE ELIMINATING ANY WAITING LIST FOR FAMILIES REQUESTING THIS PROGRAM. OUR CONTINUED SUPPORT OF THIS PROGRAM HAS RESULTED IN A THREE-YEAR TREND OF DECREASED CHILD ABUSE RATES IN WASCO COUNTY.SUBSIDY OF THE SCHOOL HEALTH SERVICES PROGRAM PROVIDES ADDITIONAL DIRECT SERVICE HOURS TO SERVE SPECIAL NEEDS STUDENTS IN THE LOCAL DISTRICT.MCMC CONDUCTS MENTORING AND INTERNSHIP PROGRAMS DESIGNED TO HELP TRAIN EXISTING AND FUTURE CARE PROVIDERS SUCH AS PHARMACY TECHNICIANS, MEDICAL ASSISTANTS, CHILD CARE PROVIDERS, RADIOLOGICAL TECHNICIANS, NURSES AND RURAL HEALTH PROVIDERS. TRAINING AND PHYSICIAN OVERSIGHT WAS PROVIDED FOR LOCAL EMS PROVIDERS.THROUGH THESE AND MANY ONGOING ACTIVITIES MID-COLUMBIA MEDICAL CENTER CONTINUES WORKING FOR HEALTHIER COMMUNITIES. | ||
| OR | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WONDERWORKS CHILDREN'S MUSEUM | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 555 | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 930686750 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 10000 | AmountOfCashGrant |
| Purpose Of Grant | PROVIDE ENGAGING ACTIVITIES FOR CHILDREN AND FAMILIES TO CULTIVATE INTELLECTUAL POTENTIAL | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
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: AN INTERNAL GRANT MANAGER TRACKS ALL EXPENSES RELATED TO THE GRANT AND REPORTS THEM PERIODICALLY IN A WRITTEN REPORT TO THE GRANTOR. SOME GRANTS CONTAIN LINE-ITEM BUDGETS WHICH ALSO MUST BE MET AND ARE SUBJECT TO AUDIT BY THE GRANTOR. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 | 1 | 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAUL CARDOSI | |||||||||||||
| 164044 | 0 | 36613 | 0 | 0 | 0 | 12076 | 0 | 12739 | 0 | 225472 | 0 | 0 | 0 |
| DUANE FRANCIS | |||||||||||||
| 0 | 454040 | 0 | 0 | 0 | 0 | 0 | 95531 | 0 | 28346 | 0 | 577917 | 0 | 0 |
| DONALD ARBON | |||||||||||||
| 0 | 215951 | 0 | 0 | 0 | 0 | 0 | 12960 | 0 | 12739 | 0 | 241650 | 0 | 0 |
| REGINA ROSE | |||||||||||||
| 158683 | 0 | 0 | 0 | 0 | 0 | 9720 | 0 | 12739 | 0 | 181142 | 0 | 0 | 0 |
| WILLIAM HAMILTON | |||||||||||||
| 292971 | 0 | 0 | 0 | 0 | 0 | 14700 | 0 | 9228 | 0 | 316899 | 0 | 0 | 0 |
| XINYU FU | |||||||||||||
| 370050 | 0 | 0 | 0 | 0 | 0 | 14700 | 0 | 12739 | 0 | 397489 | 0 | 0 | 0 |
| THOMAS NICHOL | |||||||||||||
| 231608 | 0 | 0 | 0 | 0 | 0 | 14040 | 0 | 12739 | 0 | 258387 | 0 | 0 | 0 |
| SAMUEL TAYLOR | |||||||||||||
| 225230 | 0 | 0 | 0 | 0 | 0 | 13730 | 0 | 12739 | 0 | 251699 | 0 | 0 | 0 |
| BRIAN MACARTHUR | |||||||||||||
| 225660 | 0 | 0 | 0 | 0 | 0 | 9039 | 0 | 4489 | 0 | 239188 | 0 | 0 | 0 |
| GARY GINGRICH | |||||||||||||
| 217113 | 0 | 0 | 0 | 0 | 0 | 8286 | 0 | 9228 | 0 | 234627 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 4B | DUANE FRANCIS - $80,831 |
| PART I, LINE 6 | THE INCENTIVE COMPENSATION PLAN OF $36,613 FOR THE QUALIFIED PERSON WAS BASED LARGELY ON NET PROFESSIONAL FEES. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | HEALTH CARE FOR THE MID-COLUMBIA REGION IS THE SOLE MEMBER. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF THE RETURN IS SUBMITTED TO THE BOARD OF DIRECTORS FOR REVIEW. UPDATES ARE MADE AS NECESSARY BEFORE FILING. | |
| WE ANNUALLY REQUIRE ALL OFFICERS AND DIRECTORS TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF A CONFLICT WAS DISCOVERED FOR AN EMPLOYEE OR DIRECTOR WITH A SIGNED DISCLOSURE STATEMENT, THEY WOULD BE SUBJECT TO CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION FOR VIOLATION OF OUR POLICY. IF THEY SELF-DISCLOSED A POTENTIAL CONFLICT OF INTEREST ON THE FORM, WE WOULD GATHER INFORMATION ON THE ISSUE AND MAKE A DETERMINATION ON HOW SEVERE THE CONFLICT IS AND WHETHER OR NOT THE INDIVIDUAL COULD REMAIN AN EMPLOYEE OR DIRECTOR. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY WITH EMPLOYEES AS PART OF THE PERFORMANCE REVIEW PROCESS. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE BOARD ENGAGES A PROFESSIONAL FIRM TO DO A REGIONAL AND NATIONAL SURVEY, ALONG WITH A COMPARISON OF ORGANIZATION COMPLEXITY AND STRUCTURE, AND THEN RECOMMENDS A SALARY AND BENEFITS RANGE TO THE BOARD. THIS IS ALL DONE CONFIDENTIALLY WITHOUT CEO PARTICIPATION. THE CEO THEN NEGOTIATES WITH THE BOARD, WHICH COMPARES THE COMPENSATION DISCUSSED WITH THE ANALYSIS JUST DESCRIBED AND THEN VOTES ON AND APPROVES A NEW CONTRACT IN EXECUTIVE SESSION WITHOUT CEO PRESENCE OR PARTICIPATION IN THE VOTE. THE COMPENSATION OF THE ORGANIZATION'S OFFICERS OR KEY EMPLOYEES IS DETERMINED USING A SURVEY OF MARKET RATES FOR SIMILAR POSITIONS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| AS REQUESTED. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 9,004. DECREASE IN INTEREST IN NET ASSETS OF MID-COLUMBIA HEALTH FOUNDATION -355,104. WRITE-OFF PAYABLE TO AFFILIATE - NET 24,376. TOTAL TO FORM 990, PART XI, LINE 5: -321,724. | FORM 990, PART XI, LINE 5: |
| ORGANIZATIONAL OVERSIGHT OF FINANCIAL STATEMENT AUDIT: | THE RESPONSIBILITY AND PROCESS FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| MID-COLUMBIA HEALTH FOUNDATION | ||||||||||
| 19TH NEVADA STREETS | THE DALLES | OR | 97058 | 930854433 | SUPPORT MID-COLUMBIA MEDICAL CENTER | OR | 501(C)(3) | 7 | HEALTH CARE FOR THE MID-COLUMBIA REGION | 0 |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||||||||||
| 19TH NEVADA STREETS | THE DALLES | OR | 97058 | 930847905 | HEALTH CARE SERVICES | OR | 501(C)(3) | 3 | HEALTH CARE FOR THE MID-COLUMBIA REGION | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LONE PINE HEALTH & WELLNESS CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 OSPREY LANE W | AddressLine1 |
| City | THE DALLES | City |
| State | OR | State |
| ZIP Code | 97058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263919508 | EIN |
| Primary Activity | HEALTH & WELLNESS | PrimaryActivity |
| Legal Domicile State | OR | LegalDomicileState |
| Predominant Income Type | EXCLUDED 512-514 | PredominantIncomeType |
| Share Of Total Income | -25866 | ShareOfTotalIncome |
| Share Of EOY Assets | 3971328 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
| Percentage Ownership | 0.30000 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| DRY HOLLOW PROFESSIONAL CENTER INC | ||||||||
| 1700 EAST 19TH STREET | THE DALLES | OR | 97058 | 930631350 | RENTAL BUILDING | OR | HEALTH CARE FOR THE MID-COLUMBIA REGION | C |
| MID-COLUMBIA HEALTH SERVICES | ||||||||
| 19TH NEVADA STREETS | THE DALLES | OR | 97058 | 930840781 | HEALTH & PERSONAL CARE | OR | HEALTH CARE FOR THE MID-COLUMBIA REGION | C |
| 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 | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | 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 (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MID-COLUMBIA HEALTH FOUNDATION | ||
| B | 437199 | SERVICE AGREEMENT |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| C | 793736 | CASH CONTRIBUTION RECEIVED |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| D | 71766 | LOANS TO RELATED PARTY |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||
| J | 281015 | RENTAL AGREEMENT |
| HEALTH CARE FOR THE MID-COLUMBIA REGION | ||
| L | 1080000 | MANAGEMENT CONTRACT |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| N | 295259 | EMPLOYEE GROSS PAY |
| MID-COLUMBIA HEALTH FOUNDATION | ||
| O | 141940 | ACTUAL EXPENSES |
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