2024-05-09T12:10:37-05:00 2023-06-30 135565207 KPMG LLP 1300 SW 5TH AVENUE SUITE 3800 PORTLAND OR 97201 990 2022-07-01 930579722 SALEM HEALTH SALE 5038141938 890 OAK STREET SALEM OR 97301 JAMES PARR EVP OF OPERATIONS & CFO 5038141938 2024-05-07 1 JAMES PARR 999009999 0 JAMES LANCASTER P00742579 5032216500 2024-05-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JAMES PARR 890 OAK STREET SALEM OR 97301 1008227271 0 X WWW.SALEMHEALTH.ORG X 1970 OR TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE. 13 13 5915 273 4348694 58609 9814333 3984154 958493973 1003264664 1221775 608566 -5629898 -2579434 963900183 1005277950 806029 733851 0 0 568510882 594391450 0 0 0 448187032 487607528 1017503943 1082732829 -53603760 -77454879 1722517054 2919561597 681641065 1960816350 1040875989 958745247 TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 453168704 733851 779656785 SALEM HEALTH IS ONE OF THE LARGEST OF OREGON'S 60 ACUTE HOSPITALS AND OPERATES THE BUSIEST EMERGENCY DEPARTMENT IN OREGON. THERE ARE 583 PRACTIONERS, REPRESENTING 52 DIFFERENT SPECIALTIES. MORE THAN 262 VOLUNTEERS PROVIDE NON-MEDICAL SUPPORT FOR THE HOSPITAL. STATISTICS FOR THE 12 MONTH PERIOD ENDED 06/30/23: BIRTHS - 2,975, DIAGNOSTIC IMAGING PROCEDURES - 219,591, ED VISITS - 108,002, INPATIENT ADMISSIONS - 28,338, LABORATORY PROCEDUTRES - 1,569,578, SURGERIES - 13,396. THE PRIMARY SERVICE AREA IS MARION AND POLK COUNTIES WITH APPROXIMATELY 352,249. 276168606 191596253 SALEM HEALTH PROVIDES HEALTHCARE TO PEOPLE IN OUR COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY.IN THE 12 MONTH PERIOD ENDED 06/30/2023, THE COST OF SERVICES PROVIDED AS A COMMUNITY BENEFIT TOTALED $84,572,352. THIS FIGURE CONSISTED OF $17,764,423 IN COSTS TO PROVIDE CHARITY CARE TO INDIVIDUALS WHO CANNOT AFFORD TO PAY AND $66,807,930 IN UNDERPAYMENT BY MEDICAID AS THE AMOUNT PAID UNDER THE PROGRAM WAS LESS THAN THE COST TO PROVIDE THE SERVICES; AND $33,062,480 IN UNDERPAYMENT BY MEDICARE AS THE AMOUNT PAID WAS LESS THAN THE COST TO PROVIDE THE SERVICES. 65074306 32011626 SALEM HEALTH ACTIVELY PARTICIPATES IN COMMUNITY HEALTH IMPROVEMENT SERVICES. IN THE 12 MONTHS ENDED 06/30/2023, SALEM HEALTH GAVE $1,935,990 FOR UNFUNDED OR UNDERFUNDED HEALTH SERVICES, INCLUDING COMMUNITY HEALTH EDUCATION AND PREVENTION PROGRAMS. THE HOSPITAL HAS AN ACTIVE SPEAKERS BUREAU PROVIDING FREE HEALTH LECTURES TO COMMUNITY GROUPS. HEALTH SCREENINGS, SUPPORT GROUPS AND EDUCATION CLASSES ARE OFFERED ON AN ON-GOING BASIS. IN FY2023, SALEM HEALTH PROVIDED MORE THAN $745,471 IN CASH AND IN-KIND DONATIONS TO COMMUNITY HEALTH PROGRAMS SUCH AS MEDASSIST AND PROJECT ACCESS, PSYCHIATRIC CRISIS CENTER AND THE SALEM FREE CLINIC. 794411616 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 350 0 1 5915 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X SALEM HEALTH 5038141938 890 OAK STREET SALEM OR 97301 JOHN COMBES MD CHAIR ELECT 3.70 2.30 X 0 0 0 ALAN WYNN SECRETARY/TREASURER 2.40 0.70 X X 0 0 0 RICARDO LINARES TRUSTEE 2.30 0.70 X 0 0 0 LANE SHETTERLY CHAIR 3.70 2.30 X X 0 0 0 ANNETTE CAMPISTA TRUSTEE 3.23 0.60 X 0 0 0 JENN COLUMBUS TRUSTEE 2.30 0.70 X 0 0 0 DAVID HARRISON MD TRUSTEE 2.30 0.70 X 0 0 0 THERESA HASKINS TRUSTEE 2.70 0.80 X 0 0 0 PHIL JACKSON TRUSTEE 2.30 0.70 X 0 0 0 KATHERINE L KEENE PAST CHAIR 3.90 1.10 X 0 0 0 ROBERT KELLY MD TRUSTEE 3.50 1.00 X 0 0 0 ANGELICA VEGA TRUSTEE 3.23 0.60 X 0 0 0 MARK ZOOK TRUSTEE 3.90 1.00 X 0 0 0 CHERYL R NESTER WOLFE PRESIDENT & CEO 31.90 9.10 X 1574830 0 41448 JAMES K PARR EVP OF OPERATIONS & CFO 36.00 4.00 X 981205 0 104173 LEAH M MITCHELL EVP OF OPERATIONS & CIO 40.00 0.00 X 972629 0 103773 RALPH A YATES CMO SALEM HEALTH 40.00 0.00 X 786442 0 35151 MATTHEW S BOLES VP MEDICAL AFFAIRS 40.00 0.00 X 770399 0 84120 JONATHAN H BAUER CHIEF LEGAL OFFICER 40.00 0.00 X 688029 0 80610 SARAH HORN SR VP & CHIEF NURSING & CLINICAL OPS OFFICER 40.00 0.00 X 651702 0 85733 CHRISTINE G CLARKE MD SHMG CHIEF MEDICAL OFFICER 40.00 0.00 X 633858 0 55271 KATHERINE A DOBLER VP MEDICAL GROUP 40.00 0.00 X 532073 0 69470 SHEA M CORUM CHIEF INFORMATION OFFICER 40.00 0.00 X 473073 0 69886 ZENNIA B CENIZA VP CLINICAL OPERATIONS (THRU 10/22) 40.00 0.00 X 463819 0 30194 JAIME L NICHOLS CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 437615 0 75116 DENISE B HOOVER CHIEF SURGICAL SVCS OFC (THRU 08/22) 40.00 0.00 X 436620 0 43324 LEILANI R SLAMA VP COMMUNITY ENGAGEMENT 40.00 0.00 X 403942 0 65330 JENNIFER R FOWLER VP FINANCE 40.00 0.00 X 400400 0 72772 JAMES R BAUER CHIEF DEVELOPMENT OFFICER 39.00 1.00 X 391654 0 54811 AMIE M WITTENBERG VP CLINICAL OPERATIONS 40.00 0.00 X 326098 0 43110 JUAN R OYARZUN MD DIR. CARDIOTHORATIC MEDICINE 40.00 0.00 X 1363661 0 65095 NERVIN H FANOUS MD CARDIOTHORACIC SURGEON 40.00 0.00 X 1263489 0 59599 ERIC A LARO GENERAL SURGEON 40.00 0.00 X 709385 0 65273 BRANDON H TIEU MD THORACIC SURGEON 40.00 0.00 X 678990 0 62908 NICOLE M VANDERHEYDEN MD GENERAL SURGEON HOSPITALIST 40.00 0.00 X 664883 0 71909 15604796 0 1439076 1559 0 1 0 AYA HEALTHCARE INC PO BOX 674907 DALLAS TX 752674907 CONTRACT LABOR 50654157 MEDICUS ANESTHESIA SERVICES LLC 22 ROULSTON ROAD WINDHAM NH 03087 CONTRACT LABOR 6508589 OREGON ANESTHESIOLOGY GROUP 707 SW WASHINGTON ST STE 700 PORTLAND OR 972053523 CONTRACT LABOR 3005978 ARUP LABORATORIES PO BOX 27964 SALT LAKE CITY UT 84127 CONTRACT LABOR 2652258 SALEM PULMONARY ASSOCIATES PC 801 MISSION ST SE SALEM OR 97302 CONTRACT LABOR 2096851 71 1797154 2187000 3984154 PATIENT SERVICE REV 621110 967338960 967338960 OTHER HOSPITAL SERVICE 900099 17956007 17870653 85354 PHARMACY 456110 10907184 7470637 3436547 NUTRITION SERVICES 722210 6176804 6176804 REGIONAL LAB 621500 885709 58916 826793 1003264664 779875 779875 198578 2778012 -2579434 -2579434 -2579434 171309 -171309 -171309 -171309 1005277950 998915970 4348694 -1970868 314605 314605 419246 419246 11375062 11375062 454257991 382046626 72211365 96703118 79343809 17359309 32055279 26300992 5754287 1210987 1210987 1244606 1244606 377058 377058 23250 23250 103436227 84868248 18567979 295413 295413 9895954 8119518 1776436 9300392 7630866 1669526 76757285 62978480 13778805 949884 779369 170515 935032 767183 167849 17328495 17328495 24072433 24072433 4893147 4893147 PATIENT SUPPLIES 138004434 113231069 24773365 PROVIDER TAX 52096172 52096172 OTHER PURCHASED SERVICE 19498560 19498560 BAD DEBTS 18542350 18542350 8745849 8113045 632804 1082732829 794411616 288321213 0 214312 384969 14520934 32853587 121776730 131995781 754359 149412 10789005 9538556 16736979 15292452 422955269 289454359 347575858 133500910 1112153045 2495816005 44829568 41841631 14747485 14747485 38418779 43440809 1722517054 2919561597 172204967 1461796522 12952794 15030872 490140885 478858007 6342419 5130949 681641065 1960816350 X 1034446703 951676849 6429286 7068398 1040875989 958745247 1722517054 2919561597 X -77454879 -3571537 -1104326 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 23250 23250 794388366 794411616 1000000 250000 0 0 100000 1000000 1000000 1000000 3100000 4650000 75000 82500 107050 23250 287800 4500 250000 250000 250000 754500 1131750 SCHEDULE C, PART II-A: SALEM HEALTH CONTRACTED WITH PUBLIC AFFAIRS COUNSEL TO KEEP THE HOSPITAL APPRISED OF BILLS IN THE STATE LEGISLATURE AND TO ENGAGE THE LEGISLATORS ON BEHALF OF THE HOSPITAL WHEN NECESSARY TO PROVIDE INFORMATION TO LEGISLATORS REGARDING THE IMPACT OF LEGISLATION ON THE HOSPITAL. ADDITIONALLY, THE HOSPITAL PAYS MEMBERSHIP DUES TO OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (OAHHS) AND AMERICAN HOSPITAL ASSOCIATION (AHA). A PORTION OF THE DUES TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING ACTIVITY (13.60% OF DUES TO OAHHS AND 32.00% OF DUES TO AHA) IN RELATION TO STATE AND NATIONAL HEALTHCARE ISSUES. 6507711 718810 37875 171215 7093181 4671547 1679881 305766 149483 6507711 4558231 208895 154802 250381 4671547 2981742 1758933 -1293 181151 4558231 2910663 414192 82322 425435 2981742 1.00000 0 1 1 376169658 289454359 86715299 46785611 46785611 133500910 ACCRUED MALPRACTICE INSURANCE 5008589 OTHER LIABILITIES 122360 5130949 X PART V, LINE 4: ENDOWMENT FUNDS ARE HELD BY SALEM HEALTH FOUNDATION FOR SALEM HEALTH SUPPORT. PART X, LINE 2: THE CORPORATION (SALEM HEALTH HOSPITALS & CLINICS), SALEM HEALTH, SALEM HEALTH WEST VALLEY, SALEM HEALTH FOUNDATION, WEST VALLEY HOSPITAL FOUNDATION, SALEM HEALTH PROFESSIONAL SERVICES AND WILLAMETTE VALLEY INSURANCE CORPORATION ARE TAX-EXEMPT ORGANIZATIONS PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). AS SUCH, ONLY UNRELATED BUSINESS INCOME IS SUBJECT TO FEDERAL OR STATE INCOME TAXES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CORPORATION MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO FISCAL YEAR 2020. 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 37059 17764423 17764423 0.01640 189797 258404183 191596253 66807930 0.06170 226856 276168606 191596253 84572353 0.07810 10467 1935990 13375 1922615 0.00180 770 7436315 7436315 0.00690 54869852 31998451 22871401 0.02110 86678 86678 0.00010 51604 745471 745471 0.00070 62841 65074306 32011826 33062480 0.03060 289697 341242912 223608079 117634833 0.10870 34388 34388 0.00000 0 10589 10589 0.00000 2710503 2710503 0.00250 2755480 2755480 0.00250 1 18542350 5737197 132397357 107357370 25039987 X 1 NONE 1 1 SALEM HEALTH 890 OAK STREET SALEM OR 97301 14-1428 X X X SALEM HEALTH 1 0 0 1 X X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION C X WWW.CO.POLK.OR.US/PH/COMMUNITY-HEALTH-ASSESSMENT-CHA X X 1 22 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X HTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICY X HTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICY X HTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICY X X X X X X X 1 X 0 X X X X X 1 X 0 0 SALEM HEALTH PART V, SECTION B, LINE 3J: A COMPREHENSIVE NEEDS ASSESSMENT WAS CONDUCTED IN THE FY19 AND WAS UPDATED IN TAX YEAR 2022 (FISCAL YEAR 2023). SEE LINE 5 FOR MORE INFORMATION. SALEM HEALTH PART V, SECTION B, LINE 5: A COMPREHENSIVE NEEDS ASSESSMENT WAS CONDUCTED IN THE FY19. UPDATES OCCUR ANNUALLY. PARTNERS INCLUDING SALEM HEALTH HOSPITALS AND CLINICS, KAISER PERMANENTE, SANTIAM HOSPITAL, LEGACY HEALTH, MARION COUNTY PUBLIC HEALTH, POLK COUNTY PUBLIC HEALTH, PACIFICSOURCE, WILLAMETTE HEALTH COUNCIL, AND COMMUNITY PARTNERS. THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) CYCLE IS USED TO ASSESS AND IMPROVE THE HEALTH OF THE COMMUNITY. MAPP IS A FLEXIBLE, EVIDENCED BASED FRAMEWORK, CREATED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO). EACH COMMUNITY THAT UTILIZES MAPP CONDUCTS A COMMUNITY HEALTH ASSESSMENT (CHA), WHICH CASTS A WIDE NET COLLECTING DATA IN VARIOUS WAYS TO UNDERSTAND LOCAL HEALTH AND WHY HEALTH CONDITIONS OCCUR. SALEM HEALTH PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH COOPERATION AND REPRESENTATIVES FROM SALEM HEALTH HOSPITALS AND CLINICS, KAISER PERMANENTE, SANTIAM HOSPITAL, LEGACY HEALTH, MARION COUNTY PUBLIC HEALTH, POLK COUNTY PUBLIC HEALTH, PACIFICSOURCE, WILLAMETTE HEALTH COUNCIL, AND COMMUNITY PARTNERS. SALEM HEALTH PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH THE BEHAVIORAL CARE NETWORK, CHEMEKETA COMMUNITY COLLEGE, CHERRIOTS, CITY OF WOODBURN, COMMUNITY ACTION AGENCY, COMMUNITY ADVISORY COUNCIL , EARLY LEARNING HUB, KAISER PERMANENTE, LEGACY HEALTH SILVERTON , MARION COUNTY HEALTH & HUMAN SERVICES, NORTHWEST SENIOR & DISABILITY SERVICES, POLK COUNTY HEALTH DEPARTMENT, SANTIAM HOSPITAL, WESTERN OREGON UNIVERSITY, WILLAMETTE VALLEY COMMUNITY HEALTH, PACIFICSOURCE COMMUNITY SOLUTIONS AND NUMEROUS NON-PROFIT SERVICE PROVIDER PARTNERS.PART V, SECTION B, LINE 7BWWW.CO.POLK.OR.US/PH/COMMUNITY-HEALTH-ASSESSMENT-CHA SALEM HEALTH PART V, SECTION B, LINE 7D: THE HOSPITAL MADE THE CHNA AVAILABLE TO THE COMMUNITY. THE FULL ASSESSMENT, AS WELL AS ANNUAL UPDATES, ARE POSTED TO THE HOSPITAL AND COUNTY WEBSITES. SALEM HEALTH PART V, SECTION B, LINE 11: THE TOP THREE PRIORITY AREAS DETERMINED IN THE 2019 ASSESSMENT AND IN THE TAX YEAR 2022 UPDATE ARE BEHAVIORAL HEALTH SUPPORT, SUBSTANCE USE PREVENTION, AND WITHIN SOCIAL DETERMINANTS OF HEALTH - HOUSING. SALEM HEALTH ALSO CHOSE TO ADDRESS DIABETES AND OBESITY. WHILE COVID WAS NON-EXISTENT AT THE TIME THE ORIGINAL CHNA WAS CONDUCTED, ITS IMPACT QUICKLY ECLIPSED OTHER NEEDS AND OVERWHELMED OUR PARTNERS IN PUBLIC HEALTH. DURING FY21 AND FY22, SALEM HEALTH RECOGNIZED A NEED WITHIN OUR COMMUNITY TO DISTRIBUTE VACCINATIONS AND ACTED QUICKLY TO STAND UP THE FIRST MASS VACCINATION SITE IN THE STATE OF OREGON. THIS PROVED TO BE AN EFFECTIVE AND EFFICIENT WAY TO VACCINATE OUR COMMUNITY, AS WELL AS REACH OUR VULNERABLE AND MARGINALIZED POPULATIONS. WE EXPANDED OUR FOCUS FROM VACCINES TO ADDRESSING THE DISPARITY OF INCREASED CHRONIC DISEASES, INCLUDING DIABETES, HYPERTENSION, AND HIGH BLOOD PRESSURES AMONG OUR BIPOC COMMUNITIES. USING OUR CULTURALLY COMPETENT AND TRUSTED COMMUNITY PARTNERS, SALEM HEALTH OFFERED HEALTH SCREENINGS, EDUCATION CLASSES AND CONNECTIONS TO PRIMARY CARE BY USING BILINGUAL AND BICULTURAL EMPLOYEES. COVID-19 PANDEMIC HIGHLIGHTED HEALTH DISPARITIES IMPACTING LATINOS AND IMMIGRANTS IN OUR COMMUNITY. BETWEEN 2020 AND 2022, 940,956 COVID-19 CASES WERE DETECTED IN OREGON, INCLUDING 105,969 IN THE COMMUNITY (85,980 IN MARION, 19,989 IN POLK). MARION COUNTY HAS OVER TWICE THE HISPANIC POPULATION (27%) AS THE OREGON STATE AVERAGE (13.3%). THE CHALLENGES AROUND COMMUNICATION OPTIONS IN SPANISH COMBINED WITH A LACK OF A PRIMARY CARE PROVIDER (ESPECIALLY SPANISH SPEAKING) AND OTHER NEEDS EMERGING DURING THE PANDEMIC, CREATED HIGH LEVELS OF TOXIC STRESS WITHIN THE LATINO COMMUNITY. IN TAX YEAR 2022, COMMUNITY PARTNER GRANT RECIPIENTS ARE SELECTED WITH THE IDENTIFIED COMMUNITY HEALTH NEEDS IN MIND, BUT ALSO SOCIAL DETERMINANTS OF HEALTH, HEALTH DISPARITIES AND VULNERABLE POPULATIONS. FOR EXAMPLE, THROUGH THE FOSTERING HOPE INITIATIVE (FHI), CATHOLIC COMMUNITY SERVICES USED BILINGUAL/BICULTURAL COMMUNITY HEALTH WORKERS TO TARGET 20 AFFORDABLE HOUSING AND TRANSITIONAL LIVING SITES TO CONNECT WITH INDIVIDUAL AND FAMILIES WHO HAVE INSUFFICIENT ACCESS TO HEALTH CARE SERVICES. ONCE IDENTIFIED, FHI ASSISTED INDIVIDUALS AND FAMILY'S IDENTITY TO HEALTH CARE SERVICES NEEDED, PROVIDED SUPPORT TO HELP THEM OBTAIN NEEDED SERVICES AND ENSURED INDIVIDUALS AND FAMILY FOLLOW UP WITH HEALTH CARE REFERRALS. CENSUS TRACTS WITH A HIGHER PREVALENCE OF DEPRESSION WERE CLUSTERED IN THE CITY OF SALEM AND NORTHERN INDEPENDENCE. MENTAL HEALTH PROVIDER RATE PER 100,000 CHA 2018-2022 IS OVER 400/100,000. SALEM KEIZER COLLATION FOR EQUALITY'S FORMING STRONG FAMILIES, FORMANDO FAMILIAS FUERTES, OFFERED YEAR AROUND PROJECT FOCUSED ON MENTAL AND EMOTIONAL HEALTH OF FAMILY RELATIONSHIPS. INCLUDED WERE PARENTING CLASSES, FAMILY COMMUNICATION, FAMILY ACTIVITIES, MONTHLY SPEAKERS, MENTORING AND PEER SUPPORT TO BUILD PROTECTIVE FACTORS IN FAMILIES THAT CONTRIBUTES TO THE EDUCATIONAL AND LIFE SUCCESS OF OUR CHILDREN. CHURCH @ PARK USED THEIR COMMUNITY PARTNER FUNDING IN A SIMILAR WAY, HIRING COORDINATORS WHOSE GOAL WAS TO SUPPORT 30 INDIVIDUALS EXPERIENCING HOMELESSNESS TO ESTABLISH PRIMARY CARE, SIGN UP FOR OHP, UNDERSTAND THE APPROPRIATE LEVEL OF CARE TO SEEK, REDUCE THEIR USE OF EMERGENCY SYSTEMS, STABILIZE HEALTH CONDITIONS, AND TRANSITION FROM PLACES NOT MEANT FOR HUMAN HABITATION TO MORE STABLE HOUSING. SUBSTANCE USE AND ABUSE, INCLUDING ALCOHOL, TOBACCO, AND DRUGS, REMAIN PRIMARY SOURCES OF PREVENTABLE DEATH IN THE COMMUNITY, STATE, AND THE COUNTRY. CO-OCCURRING DIAGNOSES FOR BOTH MENTAL ILLNESS AND SUBSTANCE USE DISORDERS ARE COMMON. THIS SIGNIFICANT OVERLAP BETWEEN SUBSTANCE ABUSE AND MENTAL HEALTH UNDERSCORES THE IMPORTANCE OF CAPTURING WHO IS ENGAGING IN BEHAVIORS INDICATIVE OF THESE DISORDERS IN THE COMMUNITY. THE IMPACT SUBSTANCE ABUSE HAS ON OUR COMMUNITY IS SIGNIFICANT. ABOUT 33% OF MOTOR VEHICLE FATALITIES IN MARION COUNTY INVOLVED ALCOHOL, COMPARED TO 29% IN POLK COUNTY AND 32% IN THE STATE. THE RATE OF DEATHS THAT INVOLVED ALCOHOL HAS BEEN INCREASING IN THE COMMUNITY IN RECENT YEARS. ROUGHLY 14% OF ADULT COMMUNITY MEMBERS BINGE DRINK, COMPARED TO 18% OF ADULTS IN THE STATE. IN MARION, 16% OF ADULTS WERE CURRENT CIGARETTE SMOKERS COMPARED TO 15% IN POLK AND 18% IN THE STATE. THE COMMUNITY IS NOT CURRENTLY MEETING THE HEALTHY PEOPLE 2020 GOAL FOR CIGARETTE SMOKING. TOBACCO IS THE AGENT MOST RESPONSIBLE FOR AVOIDABLE ILLNESS AND DEATH IN AMERICA TODAY. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, TOBACCO USE BRINGS PREMATURE DEATH TO ALMOST HALF A MILLION AMERICANS EACH YEAR AND IT CONTRIBUTES TO PROFOUND DISABILITY AND PAIN IN MANY OTHERS. THE WORLD HEALTH ORGANIZATION STATES THAT APPROXIMATELY ONE-THIRD OF ALL TOBACCO USERS IN THIS COUNTRY WILL DIE PREMATURELY BECAUSE OF THEIR DEPENDENCE ON TOBACCO. MARION AND POLK COUNTIES CONTINUE TO SEE A SIGNIFICANT INCREASE IN TOBACCO USE AND HAS SINCE 2011: MARION COUNTY HAS 19% OF ITS RESIDENTS' USING TOBACCO AND POLK COUNTY REPORTS 16.4%. ABOUT 15% OF ADULTS IN MARION AND POLK WERE CURRENT CIGARETTE SMOKERS, COMPARED WITH ABOUT 17% OF ADULTS IN OREGON IN 2022. THE PREVALENCE OF CIGARETTE SMOKING HAS BEEN DECREASING IN THE COMMUNITY IN RECENT YEARS, HOWEVER WE HAVE YET TO MEET THE HEALTHY PEOPLE 2020 GOAL (12%). COMMUNITY MEMBERS ENROLLED IN MEDICAID HAD A HIGHER PREVALENCE OF CIGARETTE SMOKING THAN THE COMMUNITY AS A WHOLE. TOBACCO USE CONTRIBUTES TO MANY DISEASES, ESPECIALLY LUNG CANCER, A DISEASE FROM WHICH MARION AND POLK COUNTY RESIDENTS DIE A HIGHER RATE THAN THOSE IN OTHER PARTS OF OREGON. WITH TOBACCO USE COMES A GREATER EXPOSURE TO SECONDHAND SMOKE FOR NON-SMOKERS, WHICH MAY EXACERBATE A WIDE RANGE OF ADVERSE HEALTH EFFECTS SUCH AS RESPIRATORY INFECTIONS AND ASTHMA. ESPECIALLY CONCERNING IS THE INCREASE OF TOBACCO USE DURING PREGNANCY WHICH, ALTHOUGH IT HAS DECREASED IN RECENT YEARS IS STILL FAR HIGHER AT 10% THAN THE HEALTH PEOPLE 2020 GOAL OF LESS THAN 2%. SALEM HEALTH IS A SMOKE FREE CAMPUS AND HAS WORKED WITH THE CITY OF SALEM TO EXPAND SMOKE FREE ZONES TO NEIGHBORING SIDEWALKS AND CITY PARKS. THE HOSPITAL SCREENS 100% OF ITS PATIENTS FOR TOBACCO USE AND PROVIDES ALL TOBACCO USERS WITH COMMUNITY CESSATION RESOURCE INFORMATION. THE AMERICAN LUNG ASSOCIATION'S FREEDOM FROM SMOKING CURRICULUM IS OFFERED AT NO COST THROUGH OUR COMMUNITY HEALTH EDUCATION CENTER (CHEC) AND THE HEALTH EDUCATION AND OUTREACH TEAMS PROVIDE COMMUNITY-BASED EDUCATION TO SCHOOLS RELATED TO TOBACCO PREVENTION. SALEM HEALTH TRAUMA PREVENTION TEAM CONDUCTED CLASSES AND PRESENTATIONS AROUND SUBSTANCE ABUSE INCLUDING MARIJUANA AND VAPING USE AND METHAMPHETAMINE USE. SALEM HEALTH'S CHEC ALSO HOLDS CLASSES ON DUIS, SUBSTANCE ABUSE, METH ADDICTION PREVENTION, AA PROGRAM AND AL-ANON SUPPORT GROUPS, AND MINOR IN POSSESSION CLASSES. NO AND LOW-COST HEALTH EDUCATION IS AVAILABLE TO THE GENERAL PUBLIC IN THE FORM OF CLASSES, OUTREACH AND ACCESS TO RESEARCH MATERIALS, ONLINE AND IN PRINT. A PART TIME LIBRARIAN IS ON STAFF TO ASSIST CLINICIANS WITH THE LATEST RESEARCH AND TREATMENT OPTIONS. A STAFF OF HEALTH EDUCATORS PRESENTS TO THE PUBLIC ON VARIOUS COMMUNITY HEALTH TOPICS ON REQUEST AND ATTENDS WELLNESS FAIRS, PROVIDING BIOMETRICS AND HEALTH INFORMATION. THE SALEM HEALTH'S CANCER CENTER OFFERS FREE SCREENINGS SEVERAL TIMES A YEAR FOR VARIOUS CANCERS, INCLUDING BREAST, COLON, LUNG AND SKIN CANCER. IN ADDITION, THE CANCER CENTER OFFERS EDUCATIONAL OPPORTUNITIES IN THE COMMUNITY TO LEARN ABOUT PREVENTION, INTERVENTION, AND TREATMENT OPTIONS FOR THESE CANCER TYPES. HOUSING AND HEALTHCARE WORK ARE CRITICAL PIECES IN PREVENTING AND ENDING HOMELESSNESS. HEALTHCARE SERVICES ARE MORE EFFECTIVE AND BETTER DELIVERED WHEN A PATIENT IS STABLY HOUSED. IN 2023, 1,683 COMMUNITY MEMBERS IN MARION AND POLK COUNTY WERE HOMELESS. THE RATE OF HOMELESSNESS HAS BEEN INCREASING BOTH IN THE COMMUNITY AND THE STATE IN RECENT YEARS, INCLUDING GROWING NUMBERS OF STUDENTS IN K-12 EXPERIENCING HOMELESSNESS. THIS LEADS TO INADEQUATE CARE, DIFFICULT CONNECTING TO SERVICES, AND CONTRIBUTING TO CHRONIC DISEASE. EXPOSURE TO COMMUNICABLE DISEASE INCREASES, AND CHRONIC HEALTH CONDITIONS SUCH AS HIGH BLOOD PRESSURE AND DIABETES BECOME WORSE DUE TO MEDICATION STORAGE ISSUES AND DIFFICULTY MAINTAINING A HEALTHY DIET. BEHAVIORAL HEALTH ISSUES SUCH AS DEPRESSION, ALCOHOLISM, OR OTHER SUBSTANCE USE DISORDERS CAN DEVELOP AND/OR ARE MADE WORSE IN SUCH DIFFICULT SITUATIONS. SALEM HEALTH PART V, SECTION B, LINE 13B: SALEM HEALTH FINANCIAL MATRIX IS BASED ON INCOME AS A PERCENT OF FEDERAL POVERTY LEVEL. SALEM HEALTH PART V, SECTION B, LINE 13H: CRITERIA CONSIDERED IN DETERMINING ELIGIBILITY INCLUDE, BUT ARE NOT LIMITED TO: 1) THE HOUSEHOLD'S GROSS INCOME. THE DEFINITION OF HOUSEHOLD GROSS INCOME INCLUDES THE COMBINED GROSS MONTHLY INCOME OF ALL PERSONS LEGALLY RESPONSIBLE FOR PATIENT BILL OR BALANCE.2) HOUSEHOLD'S ASSETS OTHER THAN PRIMARY RESIDENCE.3) EQUITY IN A REAL ESTATE (OTHER THAN THE PATIENT/GUARANTOR'S PRIMARY RESIDENCE), SECURITIES OR OTHER ASSETS ARE CONSIDERED AVAILABLE TO PAY THE PATIENT'S MEDICAL EXPENSES AND SHOULD BE INCLUDED IN THE INCOME CALCULATION. 4) THE INCOME FROM INCOME-PRODUCING REAL PROPERTY SHOULD BE USED IN THE CALCULATION RATHER THAN THE EQUITY. 5) INDIVIDUAL RETIREMENT ACCOUNTS (IRAS) OR OTHER RETIREMENT FUNDS WILL NOT BE INCLUDED IN HOUSEHOLD ASSETS; HOWEVER, DISTRIBUTIONS FROM THOSE FUNDS WILL BE CONSIDERED INCOME.6) FAMILY SIZE (PERSONS LEGALLY RESPONSIBLE FOR THE PATIENT BILL AND THEIR DEPENDENTS).7) THE FAMILY'S MONTHLY OUT-OF-POCKET EXPENSES FOR MEDICAL SUPPLIES AND SERVICES.8) ELIGIBILITY MAY BE CONTINGENT UPON PATIENT COOPERATION WITH THE APPLICATION PROCESS. HOUSEHOLD INCOMES UP TO 400% OF THE ANNUAL POVERTY LEVEL GUIDELINES (FPG) WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE AS OUTLINED BELOW AND IN THE FPG FINANCIAL MATRIX:FINANCIAL MATRIX INCOME AS A PERCENTAGE OF FEDERAL POVERTY LEVEL PERCENTAGE OF FPG PERCENTAGE DISCOUNT0-300% 100%301- 400% 65% SALEM HEALTH PART V, SECTION B, LINE 15E: APPLICATION PROCESS AND ELIGIBILITY DETERMINATION A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BEFORE, DURING OR AFTER THE PROVISION OF CARE. THE HOSPITAL HAS DEVELOPED AN APPLICATION PROCESS FOR DETERMINING INITIAL INTEREST IN AND QUALIFICATION FOR FINANCIAL ASSISTANCE. REQUESTS FOR FINANCIAL ASSISTANCE WILL BE ACCEPTED FROM THE PATIENT DIRECTLY, OR OTHERS ON THE PATIENT'S BEHALF. THIS COULD INCLUDE BUT IS NOT LIMITED TO, THE PATIENT'S REPRESENTATIVE OR HOSPITAL STAFF.SUPPORTING DOCUMENTATION MAY INCLUDE THE FOLLOWING: PATIENT MUST PROVIDE TWO OF THE FOLLOWING DOCUMENTS TO SUPPORT THE INCOME CLAIMS ON THE APPLICATION. THREE MONTHS INCOME VERIFICATION IN THE FORM OF PAY STUBS, BANK DEPOSITS, ETC. SOCIAL SECURITY DETERMINATION LETTERS THE PRIOR YEAR'S TAX RETURNS OR 450T-EZA "BASIC NEEDS" LETTER THAT INDICATES HOW PERSONS WITH NO INCOME ARE MEETING THEIR DAY-TO-DAY BASIC LIVING NEEDS. "BASIC NEEDS" LETTER MUST ONLY BE CONSIDERED A SECONDARY SUPPORTING DOCUMENT AFTER THE FINANCIAL COUNSELOR OR CLERK VALIDATES THAT INFORMATION. AS OUTLINED IN SALEM HEALTH'S CONDITIONS OF ADMISSION, A CREDIT BUREAU REPORT OR A CHARITY SCORING VENDOR MAY BE REQUESTED TO VALIDATE INFORMATION PROVIDED ON THE FINANCIAL ASSISTANCE APPLICATION. SALEM HEALTH MAY ACCEPT INFORMATION PROVIDED ON AN OHP APPLICATION, OHP ELIGIBILITY, PROBATE ESTATES DETERMINATION, DOCUMENTATION OF HOMELESS STATUS, OR RELIABLE THIRD-PARTY CREDIT INFORMATION AS A SUBSTITUTE FOR THE FINANCIAL FORMS. OHP INFORMATION WILL BE CONSIDERED VALID 30 DAYS PRIOR TO ADMISSION AND 90 DAYS POST DISCHARGE. APPROVED SOURCES OF DOCUMENTATION FOR HOMELESS STATUS INCLUDE CHART NOTES, DISCHARGE PLANS, OR DISCHARGE SUMMARIES ENTERED INTO OUR HEALTH INFORMATION SYSTEM BY CARE PROVIDERS OF THE PATIENT INDICATING THEY ARE HOMELESS DURING THE REGISTRATION PROCESS. FINANCIAL ASSISTANCE GRANTED BASED ON THIRD PARTY INFORMATION RATHER THAN A FINANCIAL ASSISTANCE APPLICATION DOES NOT EXTEND TO FUTURE DATES OF SERVICE AND WOULD NEED TO BE REEVALUATED BASED ON INFORMATION AVAILABLE THAT TIME. PART V, SECTION B, LINE 16-FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION MAY BE DOWNLOADED FROM OUR WEBSITE: HTTPS://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICY.-PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION ARE AVAILABLE IN THE EMERGENCY DEPARTMENT, IN REGISTRATION AREAS AND AT PATIENT FINANCIAL SERVICES, 550 HAWTHORNE SE, SUITE 200, SALEM OREGON 97301. -PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATIONS MAY BE REQUESTED BY MAIL FROM FINANCIAL COUNSELING, SALEM HEALTH, PO BOX 14001, SALEM, OR 97309-9976 OR VIA TELEPHONE BY CALLING 503-562-4357. SALEM HEALTH PART V, SECTION B, LINE 16J: INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS MADE PUBLICALLY AVAILABLE FREE OF CHARGE IN THE FOLLOWING MANNER:1. NOTICES ARE POSTED IN KEY AREAS OF THE HOSPITAL, INCLUDING ADMITTING, THE EMERGENCY DEPARTMENT, OUTPATIENT DEPARTMENT REGISTRATION AREAS, AND PATIENT FINANCIAL SERVICES.2. THE CONDITIONS OF ADMISSION FORM INFORMS THE PATIENT OF THEIR RIGHT TO APPLY FOR FINANCIAL ASSISTANCE.3. WRITTEN INFORMATION SHALL BE AVAILABLE IN ENGLISH, SPANISH, RUSSIAN AND VIETNAMESE. THE HOSPITAL WILL PROVIDE THE APPROPRIATE INTERPRETATION SERVICES FOR PATIENTS/GUARANTORS WHO DO NOT SPEAK ENGLISH.4. FRONT-LINE STAFF WILL BE TRAINED TO ANSWER FINANCIAL ASSISTANCE QUESTIONS EFFECTIVELY AND WILL DIRECT ANY THAT CANNOT BE ANSWERED TO FINANCIAL COUNSELOR'S IN A TIMELY MANNER.5. THIS POLICY WILL BE POSTED ON SALEM HEALTH'S WEBSITE. WRITTEN INFORMATION ABOUT THIS POLICY WILL BE MADE AVAILABLE UPON REQUEST.6. ALL PATIENT BILLING STATEMENTS WILL INCLUDE A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE AND CONTACT INFORMATION IF THEY WANT TO LEARN MORE. SALEM HEALTH PART V, SECTION B, LINE 18E: IT IS THE POLICY OF SALEM HEALTH TO PURSUE COLLECTION OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR SERVICES. SALEM HEALTH MAKES REASONABLE EFFORTS TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. COLLECTION PROCEDURES APPLIED CONSISTENTLY AND FAIRLY FOR ALL PATIENTS REGARDLESS OF INSURANCE STATUS. ALL COLLECTIONS PROCEDURES WILL COMPLY WITH APPLICABLE LAWS AND WITH SALEM HEALTH'S MISSION. FOR THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR OPEN BALANCES, THE FINANCIAL ASSISTANCE POLICY WILL BE FOLLOWED.COLLECTION AGENCIES AND/OR LAW FIRMS MAY BE ENLISTED AFTER REASONABLE COLLECTION AND PAYMENT OPTIONS HAVE BEEN EXHAUSTED. AGENCIES MAY HELP RESOLVED ACCOUNTS WHERE PATIENTS ARE UNCOOPERATIVE IN MAKING PAYMENTS, HAVE NOT MADE APPROPRIATE PAYMENTS OR HAVE BEEN UNWILLING TO PROVIDE REASONABLE FINANCIAL AND OTHER DATA TO SUPPORT THEIR REQUEST FOR FINANCIAL ASSISTANCE. COLLECTION AGENCY AND LAW FIRM STAFF WILL UPHOLD THE CONFIDENTIALITY AND INDIVIDUAL DIGNITY OF EACH PATIENT. ALL AGENCIES AND LAW FIRMS WILL COMPLY WITH ALL APPLICABLE LAWS INCLUDING HIPAA REQUIREMENTS FOR HANDLING PROTECTED HEALTH INFORMATION. SALEM HEALTH PART V, SECTION B, LINE 19E: SALEM HEALTH WILL NOTIFY INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE INDIVIDUALS AT LEAST 30 DAYS PRIOR TO PURSUING EXTRAORDINARY COLLECTIONS ACTIONS (ECA) TO OBTAIN PAYMENT FOR THE CARE PROVIDED BY THE HOSPITAL. ECAS FOR HOSPITAL SERVICES WILL NOT COMMENCE FOR A PERIOD OF AT LEAST 240 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT AND 30 DAYS AFTER THE HOSPITAL OR AUTHORIZED THIRD PARTY PROVIDES WRITTEN NOTICE OF ECAS THE HOSPITAL PLANS TO INITIATE FOR THE APPLICABLE MEDICALLY NECESSARY OR EMERGENCY CARE. SALEM HEALTH PART V, SECTION B, LINE 20E: SALEM HEALTH WILL NOTIFY INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE INDIVIDUALS AT LEAST 30 DAYS PRIOR TO PURSUING EXTRAORDINARY COLLECTIONS ACTIONS (ECA) AS TO OBTAIN PAYMENT FOR THE CARE PROVIDED BY THE HOSPITAL BY DOING THE FOLLOWING:1) PROVIDE WRITTEN NOTICE TO THE INDIVIDUAL INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE INDIVIDUALS, INDICATING THAT SALEM HEALTH INTENDS TO INITIATE OR HAVE A THIRD PARTY INITIATE TO OBTAIN PAYMENT FOR THE CARE AND PROVIDE A DEADLINE AFTER WHICH ECAS MAY BE PURSUED, AND WHICH IS NO SOONER THAN 30 DAYS AFTER THE DATE OF THIS WRITTEN NOTICE.2) PROVIDE THE INDIVIDUAL A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH THE WRITTEN NOTICE.3) MAKE REASONABLE EFFORTS TO ORALLY NOTIFY INDIVIDUAL ABOUT THE SALEM HEALTH'S FINANCIAL ASSISTANCE POLICY. SALEM HEALTH PART V, SECTION B, LINE 21C: NOT APPLICABLE. SALEM HEALTH HAS A POLICY RELATIVE TO EMERGENCY MEDICAL CARE THAT REQUIRED THE HOSPITAL FACILITY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SALEM HEALTH PART V, SECTION B, LINE 21D: NOT APPLICABLE. SALEM HEALTH HAS A POLICY RELATIVE TO EMERGENCY MEDICAL CARE THAT REQUIRED THE HOSPITAL FACILITY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.PART V, SECTION B, LINE 11 ( CONTINUED)SALEM HEALTH SUPPORTS COMMUNITY PARTNERS AND THEIR EFFORTS TO ADDRESS HOUSING AND HOMELESSNESS AND LOOKS INTERNALLY TO SUPPORT PATIENT CONNECTIONS WITH SERVICE PROVIDERS. FOR EXAMPLE, SALEM HEALTH WORKED WITH COMMUNITY PARTNERS TO COVER ADMINISTRATIVE COSTS OF THE MID-WILLAMETTE VALLEY HOMELESS ALLIANCE WITH HUD AND SUPPORTS A COMMUNITY DATABASE ESTABLISHING A SYSTEM FOR ALL PROVIDERS TO LOG ONTO THE SAME SHARED INFORMATION FOR YOUTH HOMELESS SUPPORTS AND COORDINATION. IN ADDITION, SALEM HEALTH CREATED A RIGHT CARE AT THE RIGHT TIME FLYER TO SUPPORT HOMELESS SERVICES PROVIDERS ACCESS CARE AND FIND THE CORRECT CARE FOR THEIR CLIENTS. ACCOMPANYING THIS FLYER IS THE FREQUENTLY ASKED QUESTIONS FLYER FOR COMMUNITY HOMELESS SERVICE PROVIDERS. THIS FLYER DETAILS HOW PROVIDERS CAN SUPPORT THEIR CLIENTS WHILE THEY ARE IN CARE AT THE HOSPITAL, WORK WITH THEIR CLIENT TO ACCESS CARE INFORMATION, AND SUPPORT A SAFER TRANSITION FROM HOSPITAL CARE BACK TO THE COMMUNITY FOR IMPROVED HEALTH OUTCOMES. COMMUNITY WIDE TASKFORCES ARE IN PLACE TO ADDRESS HOMELESSNESS, WHICH IS DEEMED A CRITICAL ISSUE IN THE TWO COUNTIES SERVED BY SALEM HEALTH. REPRESENTATIVES FROM APPROPRIATE AREAS OF THE HOSPITAL ATTEND TASKFORCE MEETINGS AND LEVERAGE HOSPITAL RESOURCES TO POSITIVELY IMPACT HEALTH OUTCOMES. HOSPITAL LEADERS VOLUNTEER TIME TO SERVE ON COMMUNITY NON-PROFIT BOARDS WHICH MIRROR THE MISSION OF SALEM HEALTH AND ATTEND REGIONAL COLLABORATIVE WORK GROUPS THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH. EXAMPLES INCLUDE BOARD POSITIONS ON MID-WILLAMETTE VALLEY HOMELESS ALLIANCE, SALEM FREE CLINIC, FAMILY BUILDING BLOCKS, MARION POLK FOOD SHARE, THE BOYS & GIRLS CLUB, UNITED WAY, UNION GOSPEL MISSION, LIBERTY HOUSE, AND CATHOLIC COMMUNITY SERVICES. WORKFORCE HAS EMERGED AS A NEED NOT IDENTIFIED IN PREVIOUS ASSESSMENTS, BUT CERTAINLY AN ISSUE THAT IMPACTS THE COMMUNITY. SALEM HEALTH PROVIDES TRAINING FOR NURSING STUDENTS, CLINICAL ROTATIONS FOR PHYSICAL AND OCCUPATIONAL THERAPISTS, PHARMACISTS, AND DIETITIANS AS WELL AS OTHER HEALTH PROFESSIONALS. IN ADDITION, SALEM HEALTH IS PARTNERING WITH EMERGING HEALTHCARE PROFESSIONAL CURRICULUMS IN HIGH SCHOOL AND GIVING OPPORTUNITIES TO EXPLORE CAREERS THROUGH ENGAGEMENT WITH HEALTH CARE PROFESSIONALS AND ONSITE JOB SHADOWS. SALEM HEALTH LEADERS AND CONTINUALLY ENGAGED IN ADVANCING HEALTHCARE SUPPORTS AND WORKFORCE THROUGH STATEWIDE AND NATIONAL BOARDS. TOGETHER, WE WORK ON INITIATIVES AND IMPLEMENT PROGRAMS AIMED AT IMPACTING AND ALIGNING KEY LEVERS OR STRATEGIES TO PRODUCE OUTCOMES THAT IMPROVE HEALTH AND CREATE A BETTER HEALTHCARE SYSTEM THROUGH SYSTEM WIDE QUALITY IMPROVEMENT, CARE MANAGEMENT, CONSULTING AND RESEARCH, AND HEALTH INFORMATION TECHNOLOGY AND ANALYTICS. SALEM HEALTH'S CEO SERVED ON THE OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS; THE CHIEF NURSING OFFICER SERVES ON THE OREGON STATE BOARD OF NURSING, WHOSE GOALS ARE TO PROTECT THE PUBLIC BY REGULATING NURSING EDUCATION, LICENSURE, AND PRACTICE; AND HAVE EMPLOYEES WHO SERVE GOVERNMENTAL ADVOCACY FOR MEDICAL GROUPS AND POLICY SUPPORT FOR PATIENT SERVICES. THE HOSPITAL PROVIDES COMMUNITY BASIC HEALTH IMPROVEMENT SERVICES AS REQUESTED IN MARION AND POLK COUNTIES. IN 2023, THESE INCLUDED BIOMETRIC AND DIABETIC SCREENINGS, AND EDUCATION AND OUTREACH ON A VARIETY OF HEALTH TOPICS. THE COMMUNITY HEALTH EDUCATION CENTER (CHEC) OFFERS A HEALTH-RELATED LENDING LIBRARY, DROP-IN NURSING CONSULTATION SERVICES AND GROUP INSTRUCTION. THE CHEC PROVIDES SPACE FREE OF CHARGE TO COMMUNITY PARTNERS SEEKING TO IMPROVE HEALTH OUTCOMES. THE ROOMS HOST CLASSES, LECTURES, HEALTH FAIRS AND SUPPORT GROUPS THAT ARE COORDINATED IN PARTNERSHIP WITH COMMUNITY AGENCIES. DIABETIC AND NUTRITION COUNSELING IS ALSO OFFERED FOR PATIENTS NEWLY DIAGNOSED AND UNABLE TO PAY FOR THESE SERVICES. SEVERAL OUTREACH ACTIVITIES ARE FACILITATED BY TRAUMA NURSES. EXAMPLES INCLUDE HELMET SAFETY, DRIVING SAFETY, SUBSTANCE USE PREVENTION FOR MIDDLE AND HIGH SCHOOL STUDENTS, COURT ORDERED HIGH RISK DRIVING COURSES, AND STOP THE BLEED. FINALLY, SALEM HEALTH OPERATES AN ACCREDITED DIABETIC AND NUTRITION CENTER WITH REGISTERED DIETITIANS AND CERTIFIED NURSES THROUGH THE NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS OFFERING EVIDENCE-BASED PRACTICES AND ACCEPTS REFERRALS FROM ALL PROVIDERS SUPPORTING PATIENT'S AS THEY SEEK TO IMPROVE THEIR HEALTH LIVING WITH DIABETES. SERVICES INCLUDE COMPREHENSIVE DIETARY EVALUATION AND NUTRITION, MEDICATION MANAGEMENT, AND TECHNOLOGY ENHANCEMENTS TO IMPROVE THE PATIENT OUTCOMES. SALEM HEALTH PROVIDED COMMUNITY PARTNER GRANTS IN 2023 TO ENHANCE EXISTING NON-PROFIT ORGANIZATIONS' WORK TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT, SALEM HEALTH IDENTIFIED ISSUES FACING OUR COMMUNITIES: SUBSTANCE ABUSE PREVENTION, OBESITY AND DIABETES, AND ACCESS TO HEALTHCARE AND BEHAVIORAL HEALTH SERVICES. WE INVESTED OVER $270,000 THIS YEAR IN THE FOLLOWING ORGANIZATIONS: CATHOLIC COMMUNITY SERVICES, CHURCH AT THE PARK, MID-WILLAMETTE VALLEY HOMELESS ALLIANCE, MARION COUNTY LAW ENFORCEMENT ASSISTED DIVERSION, LIBERTY HOUSE, BOYS AND GIRLS CLUB, POLK COUNTY SERVICE INTEGRATION TEAMS, SALEM FREE CLINICS, THE GATE YOUTH CENTER, SALEM PASTORAL COUNSELING CENTER, AND SALEM-KEIZER COALITION FOR EQUALITY. COMMUNITY PARTNER GRANT RECIPIENTS ARE SELECTED WITH THE IDENTIFIED COMMUNITY HEALTH NEEDS IN MIND, BUT ALSO SOCIAL DETERMINANTS OF HEALTH, HEALTH DISPARITIES AND VULNERABLE POPULATIONS. FOR EXAMPLE, THROUGH THE FOSTERING HOPE INITIATIVE (FHI), CATHOLIC COMMUNITY SERVICES USED BILINGUAL/BICULTURAL COMMUNITY HEALTH WORKERS TO TARGET 20 AFFORDABLE HOUSING AND TRANSITIONAL LIVING SITES TO CONNECT WITH INDIVIDUAL AND FAMILIES WHO HAVE INSUFFICIENT ACCESS TO HEALTH CARE SERVICES. ONCE IDENTIFIED, FHI ASSISTED INDIVIDUALS AND FAMILY'S IDENTITY TO HEALTH CARE SERVICES NEEDED, PROVIDED SUPPORT TO HELP THEM OBTAIN NEEDED SERVICES AND ENSURED INDIVIDUALS AND FAMILY FOLLOW UP WITH HEALTH CARE REFERRALS. LIBERTY HOUSE ADDED TWO THERAPISTS TO PROVIDE MENTAL HEALTH SERVICES FOR 100 NEW CASES PER YEAR WITH TRAUMA-INFORMED, EVIDENCE-BASED COUNSELING AND MENTAL HEALTH SUPPORT FOR YOUTH AND FAMILIES WHO HAVE EXPERIENCED ABUSE AND NEGLECT. SALEM PASTORAL COUNSELING PROVIDED FREE OR REDUCED COUNSELING SERVICES TO THE FINANCIALLY MARGINALIZED IN MARIAN/POLK COUNTIES. THIS GRANT PROVIDED AT LEAST 700 HOURS OF COUNSELING SESSIONS FOR MORE THAN 100 LOW-INCOME PEOPLE. CATHOLIC COMMUNITY SERVICES PROJECT PROVIDED CHW OUTREACH TO ALL HOUSEHOLDS RESIDING IN 20 AFFORDABLE HOUSING COMPLEXES OR TRANSITIONAL LIVING SITES, APPROXIMATELY 240 FAMILIES, AND DIRECT SERVICES TO 120 OF THESE FAMILIES. SALEM FREE CLINIC'S GRANT SUPPORTED INCREASING ACCESS TO HEALTHCARE, BEHAVIORAL HEALTHCARE, AND DIABETES MANAGEMENT CARE FOR UNINSURED/UNDERINSURED PATIENTS IN MARION AND POLK COUNTIES. OVER THE GRANT AWARD YEAR, SFC PROVIDED 5,500 FREE PATIENT VISITS. THESE ARE EXAMPLES OF HOW SALEM HEALTH COLLABORATES WITH THOSE ON OUR COMMUNITY'S FRONT LINE TO SUPPORT AND ENHANCE THE VERY IMPORTANT WORK OF SERVING OUR MOST VULNERABLE POPULATIONS. ADDITIONAL FINANCIAL GRANTS ARE ISSUED TO NON-PROFITS THAT ADDRESSED HEALTHY LIFESTYLE CHANGES THROUGH POSITIVE YOUTH DEVELOPMENT WITH AGE-APPROPRIATE PROGRAMING SUPPORTING YOUTH FROM 1ST THROUGH 12TH GRADES, SETTING YOUTH UP FOR A HEALTHY PLATFORM TO GROW AND DEVELOP. AT THE BOYS & GIRLS CLUB, SALEM HEALTH INVESTED IN THEIR PROGRAM TRIPLE PLAY. THIS PROGRAM BUILDS SKILLS, ATTITUDES, KNOWLEDGE, AND BEHAVIORS ESSENTIAL TO AN OVERALL HEALTH LIFESTYLE. HEALTHY EATING, PHYSICAL ACTIVITY AND RELATIONSHIP BUILDING ARE ADDRESSED IN HEALTH HABITS, DAILY CHALLENGES, AND SOCIAL RECREATION. TOGETHER, THE PROGRAM HELPS YOUNG PEOPLE LEARN TO SUSTAIN THE HEALTH OF THEIR MIND, BODY, AND SOUL. 12 1 - REHABILITATION CENTER 755 MISSION ST SE SALEM OR 97302 REHABILITATION 2 - LABORATORY PHILEBOTOMY SITE 1600 STATE ST SALEM OR 97301 LABORATORY SERVICES 3 - COMPREHENSIVE PAIN CENTER 875 OAK STREET SALEM OR 97302 PAIN MANAGEMENT 4 - REGIONAL LABORATORY 3300 STATE ST SALEM OR 97301 LABORATORY SERVICES 5 - SALEM HEALTH MEDICAL CLINIC - W SALEM 1049 EDGEWATER ST NW SUITE 150 SALEM OR 97304 CLINIC 6 - SALEM HEALTH MEDICAL CLINIC -BOULDER CRE 2485 12TH ST SE SALEM OR 97302 CLINIC 7 - SALEM HEALTH MEDICAL CLINIC - EDGEWATER 1049 EDGEWATER ST NW SALEM OR 97304 CLINIC 8 - SALEM HEALTH MEDICAL CLINIC - KEIZER 5100 RIVER ROAD N SALEM OR 97303 CLINIC 9 - SALEM HEALTH MEDICAL CLINIC - SKYLINE VL 5050 SKYLINE VILLAGE LOOP SALEM OR 97306 CLINIC 10 - SALEM HEALTH MEDICAL CLINIC - MONMOUTH 512 MAIN ST E SUITE 300 MONMOUTH OR 97361 CLINIC 11 - SALEM HEALTH MEDICAL CLINIC - UGLOW AVE 1000 SE UGLOW AVE DALLAS OR 97338 CLINIC 12 - SALEM HEALTH MEDICAL CLINIC - WOODBURN 105 ARNEY ROAD SUITE 130 WOODBURN OR 97071 CLINIC PART I, LINE 3C: CRITERIA CONSIDERED IN DETERMINING ELIGIBILITY INCLUDE BUT ARE NOT LIMITED TO: 1) THE HOUSEHOLD'S GROSS INCOME. THE DEFINITION OF HOUSEHOLD GROSS INCOME INCLUDES THE COMBINED GROSS MONTHLY INCOME OF ALL PERSONS LEGALLY RESPONSIBLE FOR PATIENT BILL OR BALANCE.2) HOUSEHOLD'S ASSETS OTHER THAN PRIMARY RESIDENCE.3) EQUITY IN A REAL ESTATE (OTHER THAN THE PATIENT/GUARANTOR'S PRIMARY RESIDENCE), SECURITIES OR OTHER ASSETS ARE CONSIDERED AVAILABLE TO PAY THE PATIENTS' MEDICAL EXPENSES AND SHOULD BE INCLUDED IN THE INCOMES CALCULATION.THE INCOME FROM INCOME-PRODUCING REAL PROPERTY SHOULD BE USED IN CALCULATION RATHER THAN THE EQUITYINDIVIDUAL RETIREMENT ACCOUNTS (IRAS) OR OTHER RETIREMENT FUNDS WILL NOT BE INCLUDED IN HOUSEHOLD ASSETS, HOWEVER DISTRIBUTIONS FROM THOSE FUNDS WILL BE CONSIDERED INCOME. * FAMILY SIZE (PERSONS LEGALLY RESPONSIBLE FOR THE PATIENT BILL AND THEIR DEPENDENTS) * THE FAMILY'S MONTHLY OUT-OF-POCKET EXPENSES FOR MEDICAL SUPPLIES AND SERVICES * ELIGIBILITY MAY BE CONTINGENT UPON PATIENT COOPERATION WITH THE APPLICATION PROCESS. THE DEFINITION OF "HOUSEHOLD GROSS INCOME" INCLUDES THE COMBINED GROSS MONTHLY INCOME OF ALL PERSONS LEGALLY RESPONSIBLE FOR PATIENT BILL OR BALANCE.SUPPORTING DOCUMENTATION MAY INCLUDE THE FOLLOWING: PATIENT MUST PROVIDE TWO OF THE FOLLOWING DOCUMENTS TO SUPPORT THE INCOME CLAIMS ON THE APPLICATION. THREE MONTHS INCOME VERIFICATION IN THE FORM OF PAY STUBS, BANK DEPOSITS, ETC. SOCIAL SECURITY DETERMINATION LETTERS THE PRIOR YEAR'S TAX RETURNS OR 450T-EZ A "BASIC NEEDS" LETTER THAT INDICATES HOW PERSONS WITH NO INCOME ARE MEETING THEIR DAY TO DAY BASIC LIVING NEEDS. "BASIC NEEDS" LETTER MUST ONLY BE CONSIDERED A SECONDARY SUPPORTING DOCUMENT AFTER THE FINANCIAL COUNSELOR OR CLERK VALIDATES THAT INFORMATION. AS OUTLINED IN SALEM HEALTH'S CONDITIONS OF ADMISSION, A CREDIT BUREAU REPORT OR A CHARITY SCORING VENDOR MAY BE REQUESTED TO VALIDATE INFORMATION PROVIDED ON THE FINANCIAL ASSISTANCE APPLICATION. SALEM HEALTH MAY ACCEPT INFORMATION PROVIDED ON AN OHP APPLICATION, OHP ELIGIBILITY, PROBATE ESTATES DETERMINATION, DOCUMENTATION OF HOMELESS STATUS, OR RELIABLE THIRD PARTY CREDIT INFORMATION AS A SUBSTITUTE FOR THE FINANCIAL FORMS. OHP INFORMATION WILL BE CONSIDERED VALID 30 DAYS PRIOR TO ADMISSION AND 90 DAYS POST DISCHARGE. APPROVED SOURCES OF DOCUMENTATION FOR HOMELESS STATUS INCLUDE CHART NOTES, DISCHARGE PLANS, OR DISCHARGE SUMMARIES ENTERED INTO OUR HEALTH INFORMATION SYSTEM BY CARE PROVIDERS OF THE PATIENT INDICATING THEY ARE HOMELESS DURING THE REGISTRATION PROCESS. FINANCIAL ASSISTANCE GRANTED BASED ON THIRD PARTY INFORMATION RATHER THAN A FINANCIAL ASSISTANCE APPLICATION DOES NOT EXTEND TO FUTURE DATES OF SERVICE AND WOULD NEED TO BE REEVALUATED BASED ON INFORMATION AVAILABLE THAT TIME. PART I, LINE 6A: A COMMUNITY BENEFIT REPORT WAS PUBLISHED AND IS AVAILABLE AT HTTPS://WWW.SALEMHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-BENEFIT-REPORTS. PART I, LINE 7: THE RATIO OF PATIENT CARE COST TO CHARGES WAS USED TO CALCULATE THE TOTAL COMMUNITY BENEFIT EXPENSE ON LINE 7, COLUMN C. THIS RATIO WAS APPLIED TO TOTAL FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS THAT ACCOUNT FOR A LARGE PORTION OF SALEM HEALTH'S COMMUNITY BENEFIT CONTRIBUTION. ENSURING THAT COMMUNITY MEMBERS HAVE ACCESS TO EMERGENCY, PRIMARY CARE AND OTHER HEALTH SERVICES REGARDLESS OF ABILITY TO PAY ALIGNS WITH THE HOSPITAL MISSION AND COMMITMENT TO SERVE THOSE LIVING IN MARION AND POLK COUNTIES. PART II: SALEM HEALTH IS DEEPLY EMBEDDED IN THE COMMUNITY AND HOSPITAL LEADERS WORK HAND IN HAND WITH REPRESENTATIVES FROM GOVERNMENT AGENCIES AND OTHER NON-PROFIT ORGANIZATIONS TO ASSESS AND ADDRESS COMMUNITY NEEDS. THREE AREAS CURRENTLY IDENTIFIED AS PRIORITIES ARE BEHAVIORAL HEALTH SUPPORT, SUBSTANCE USE PREVENTION, AND WITHIN SOCIAL DETERMINANTS OF HEALTH- HOUSING. COMMUNITY-WIDE TASKFORCES ARE IN PLACE TO ADDRESS THESE HEALTH NEEDS, WHICH ARE DEEMED MOST CRITICAL IN THE TWO COUNTIES SERVED BY SALEM HEALTH. REPRESENTATIVES FROM APPROPRIATE AREAS OF THE HOSPITAL ATTEND TASKFORCE MEETINGS AND LEVERAGE HOSPITAL RESOURCES TO POSITIVELY IMPACT HEALTH OUTCOMES. HOSPITAL LEADERS VOLUNTEER TIME TO SERVE ON COMMUNITY NON-PROFIT BOARDS WHICH MIRROR THE MISSION OF SALEM HEALTH AND ATTEND REGIONAL COLLABORATIVE WORK GROUPS THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH. EXAMPLES INCLUDE BOARD POSITIONS ON MID-WILLAMETTE VALLEY HOMELESS ALLIANCE, SALEM FREE CLINIC, FAMILY BUILDING BLOCKS, MARION POLK FOOD SHARE, THE BOYS AND GIRLS CLUB, UNITED WAY, UNION GOSPEL MISSION, LIBERTY HOUSE, AND CATHOLIC COMMUNITY SERVICES.THE HOSPITAL PROVIDES COMMUNITY BASIC HEALTH IMPROVEMENT SERVICES AS REQUESTED IN MARION AND POLK COUNTIES. IN TAX YEAR 2022, THESE INCLUDED BIOMETRIC AND DIABETIC SCREENINGS, AND EDUCATION AND OUTREACH ON A VARIETY OF HEALTH TOPICS. EXPANDING ON THIS WORK, THE COMMUNITY HEALTH EDUCATION CENTER (CHEC) HAS ALSO WORKED ALMOST EXCLUSIVELY WITH THE LATINX COMMUNITY OFFERING 17 MEDICAL SCREENING DAYS THROUGHOUT THE COMMUNITY AND A NUMBER OF THESE SCREENINGS WERE IN COLLABORATION WITH OTHER ORGANIZATIONS IN MARION AND POLK COUNTIES. EACH INDIVIDUAL WHO ATTENDED A SCREENING WAS ABLE TO GET THEIR RESULTS ON THE SAME DAY AND RECEIVE EDUCATION ON HEALTHY LIFESTYLE HABITS TO HELP THEM IMPROVE OR MAINTAIN THEIR CURRENT LIFESTYLE. THE GOAL WITH THESE LATINX SCREENINGS WAS TO RAISE AWARENESS OF THE RISK FOR PREDIABETES/DIABETES AMONG OUR UNDERSERVED POPULATIONS AND CONNECT THEM WITH PRIMARY CARE PROVIDERS. THE CHEC IS PHYSICALLY LOCATED ON THE HOSPITAL CAMPUS OFFERS A HEALTH-RELATED LENDING LIBRARY, DROP-IN NURSING CONSULTATION SERVICES AND GROUP INSTRUCTION. THE CHEC PROVIDES SPACE FREE OF CHARGE TO COMMUNITY PARTNERS SEEKING TO IMPROVE HEALTH OUTCOMES. THE ROOMS HOST CLASSES, LECTURES, HEALTH FAIRS AND SUPPORT GROUPS THAT ARE COORDINATED IN PARTNERSHIP WITH COMMUNITY AGENCIES. FINALLY, SALEM HEALTH OPERATES AN ACCREDITED DIABETIC AND NUTRITION CENTER WITH REGISTERED DIETITIANS AND CERTIFIED NURSES THROUGH THE NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS OFFERING EVIDENCE-BASED PRACTICES AND ACCEPTS REFERRALS FROM ALL PROVIDERS SUPPORTING PATIENT'S AS THEY SEEK TO IMPROVE THEIR HEALTH LIVING WITH DIABETES. SERVICES INCLUDE COMPREHENSIVE DIETARY EVALUATION AND NUTRITION, MEDICATION MANAGEMENT, AND TECHNOLOGY ENHANCEMENTS TO IMPROVE THE PATIENT OUTCOMES. SALEM HEALTH PROVIDED COMMUNITY PARTNER GRANTS IN TAX YEAR 2022 TO ENHANCE EXISTING NON-PROFIT ORGANIZATIONS' WORK TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT, SALEM HEALTH IDENTIFIED ISSUES FACING OUR COMMUNITIES: SUBSTANCE ABUSE PREVENTION, OBESITY AND DIABETES, AND ACCESS TO HEALTHCARE AND BEHAVIORAL HEALTH SERVICES. WE INVESTED OVER $320,000 THIS YEAR IN ORGANIZATIONS THAT INCLUDE CATHOLIC COMMUNITY SERVICES; CHURCH AT THE PARK; MID-WILLAMETTE VALLEY HOMELESS ALLIANCE; MARION COUNTY LAW ENFORCEMENT ASSISTED DIVERSION; LIBERTY HOUSE; BOYS AND GIRLS CLUB, POLK COUNTY SERVICE INTEGRATION TEAMS; SALEM FREE CLINICS; THE GATE YOUTH CENTER; SALEM PASTORAL COUNSELING CENTER, AND SALEM-KEIZER COALITION FOR EQUALITY. PART III, LINE 2: BAD DEBT EXPENSE IS PRIMARILY ESTIMATED BASED UPON THE HOSPITALS' HISTORICAL COLLECTION EXPERIENCE, THE AGE OF THE PATIENT'S ACCOUNT, THE PATIENT'S ECONOMIC ABILITY TO PAY, AND THE EFFECTIVENESS OF COLLECTION EFFORTS. PATIENT ACCOUNTS RECEIVABLE BALANCES ARE ROUTINELY REVIEWED IN CONJUNCTION WITH HISTORICAL COLLECTION RATES AND OTHER ECONOMIC CONDITIONS THAT MIGHT ULTIMATELY AFFECT THE COLLECTABILITY OF PATIENT ACCOUNTS WHEN CONSIDERING THE ADEQUACY OF THE AMOUNTS RECORDED IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACTUAL WRITE-OFFS HISTORICALLY HAVE APPROXIMATED MANAGEMENT'S EXPECTATIONS. PART III, LINE 3: BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER SALEM HEALTH'S FINANCIAL ASSISTANCE POLICY IS ESTIMATED BASED ON DATA FROM OUR PATIENT ACCOUNTING SYSTEM. THIS DATA IS THEN COMPARED AND MATCHED TO MEDIAN HOUSEHOLD INCOME CENSUS DATA BY ZIP CODE TO DETERMINE THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT AN ESTIMATED COLLECTIBLE AMOUNT AND DO NOT BEAR INTEREST. EXPLICIT PRICE CONCESSIONS ARE ESTABLISHED AS A RESULT OF NEGOTIATED REIMBURSEMENT METHODOLOGIES WITH THIRD PARTY PAYORS.THE CORPORATION ALSO RECORDS ESTIMATED IMPLICIT PRICE CONCESSIONS (BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE) RELATED TO UNINSURED ACCOUNTS TO RECORD SELF-PAY REVENUES AT THE ESTIMATED AMOUNTS WE EXPECT TO COLLECT. THE CORPORATION DOES NOT ASSESS CREDIT RISK BEFORE SERVICES ARE RENDERED. PART III, LINE 8: MEDICARE PAYS A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR ENROLLEES SUCH THAT THE NET REIMBURSEMENT DOES NOT COVER THE EXPENSES INCURRED TO PROVIDE THE SERVICES. SALEM HEALTH CONSIDERS THE DIFFERENCE BETWEEN THE COSTS TO PROVIDE THE SERVICES FOR MEDICARE ENROLLEES AND THE NET REIMBURSEMENT AS A BENEFIT TO THE COMMUNITY. MEDICARE FEE-FOR-SERVICE COSTS ARE DETERMINED FROM SALEM HEALTH'S FILED MEDICARE COST REPORT. THE CALCULATION OF NET BENEFIT IS EQUAL TO TOTAL MEDICARE PAYMENTS LESS MEDICARE COSTS.IN ADDITION TO TRADITIONAL MEDICARE FEE-FOR-SERVICE, SALEM HEALTH PROVIDES SUBSTANTIAL SERVICES TO OTHER MEDICARE POPULATIONS PARTICIPATING IN MEDICARE ADVANTAGE PLANS AT SIGNIFICANTLY REDUCED REIMBURSEMENT. THE NET REVENUES FOR THESE PLANS ARE LESS THAN THE COST TO PROVIDE CARE AND ARE NOT DISCLOSED IN PART III, LINE 8. SALEM HEALTH ALSO CONSIDERS THE DIFFERENCE BETWEEN THE NET COST TO PROVIDE CARE FOR MEDICARE ADVANTAGE ENROLLEES AND THE NET REIMBURSEMENT AS A BENEFIT TO THE COMMUNITY. THESE NET COSTS HAVE BEEN DETERMINED BY APPLYING THE RATIO OF COSTS TO CHARGES AS DETERMINED IN WORKSHEET 2 TO THE FULL BILLED CHARGES. THE CALCULATION OF NET BENEFIT IS EQUAL TO TOTAL MEDICARE ADVANTAGE PAYMENTS OF $238,308,725 LESS MEDICARE ADVANTAGE COSTS OF $332,399,399 FOR A TOTAL ADDITIONAL COMMUNITY BENEFIT IN THE AMOUNT OF $94,090,674. PART III, LINE 9B: THE BILLING AND COLLECTIONS ADMINISTRATIVE HOUSE-WIDE POLICY AND PROCEDURE STATES, "IF A PATIENT SUBMITS A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, SALEM HEALTH WILL SUSPEND THE ECAS UNTIL THE PATIENT'S APPLICATION HAS BEEN PROCESSED AND NOTIFY THE PATIENT OF DETERMINATION. IF AN INDIVIDUAL IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ANY ECAS WILL BE REVERSED. PART V, LINE 7A & 10A WWW.SALEMHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART VI, LINE 3: PLEASE SEE ABOVE NARRATIVE, PART V, SECTION B, LINES 13-16 PART VI, LINE 4: MARION AND POLK COUNTIES ARE IN THE WILLAMETTE VALLEY AND ARE THE 5TH AND 13TH MOST POPULOUS COUNTIES IN OREGON RESPECTIVELY. THIS COMMUNITY SPANS ABOUT 1,950 SQUARE MILES, OF WHICH 1,200 ARE IN MARION AND 750 ARE IN POLK. IN MARION, THE FIVE LARGEST CITIES ARE KEIZER, SALEM, SILVERTON, STAYTON, AND WOODBURN, WHICH ARE HOME TO 66% OF THE COUNTY'S TOTAL POPULATION. THE REMAINING 34% LIVE IN ONE OF THE SMALLER 15 CITIES OR ON UNINCORPORATED LAND. IN POLK, THE LARGEST CITIES ARE DALLAS, FALLS CITY, INDEPENDENCE, MONMOUTH, WEST SALEM, AND WILLAMINA, OF WHICH ABOUT 84% OF POLK'S POPULATION RESIDES. THOSE WHO LIVE OUTSIDE OF THE MAJOR POPULATION AREAS IN THE COMMUNITY MAY EXPERIENCE GREATER DIFFICULTY ACCESSING RESOURCES LIKE HEALTH CARE SERVICES AND HEALTHY FOODS. TRANSPORTATION CAN BE DIFFICULT GIVEN THE LIMITED PUBLIC TRANSPORTATION IN THESE RURAL AREAS.KEY FINDINGS FOR MARION & POLK COUNTIES: A GREATER PERCENTAGE OF THE COMMUNITY POPULATION IS YOUNGER, UNDER THE AGE OF 25, THAN OREGON. THE COMMUNITY HAS A LARGER PERCENTAGE OF MEMBERS THAT IDENTIFIED AS HISPANIC OR LATINX THAN OREGON. ABOUT 27% IDENTIFIED AS HISPANIC/LATINX IN MARION, COMPARED TO 14% IN POLK AND 13% IN OREGON. THE COMMUNITY HAS A HIGHER PERCENTAGE OF MEMBERS THAT SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME THAN OREGON. ROUGHLY, 1 IN 4 HOUSEHOLDS (25%) IN MARION SPEAK A LANGUAGE OTHER THAN ENGLISH, COMPARED WITH 12% IN POLK AND 15% IN OREGON. THE MOST COMMON LANGUAGES SPOKEN AFTER ENGLISH WERE SPANISH, VARIOUS ASIAN OR PACIFIC ISLANDER LANGUAGES, AND RUSSIAN. ABOUT 15% OF COMMUNITY MEMBERS ARE LIVING WITH A DISABILITY, WHICH HAS BEEN DECREASING OVER TIME. THE MOST COMMON TYPES OF DISABILITIES IN THE COMMUNITY WERE DIFFICULTIES WALKING, LIVING ALONE, OR COGNITIVE. THE PROPORTION OF COMMUNITY MEMBERS LIVING WITH A DISABILITY DIFFERED BY RACE AND ETHNICITY. ONE THIRD (33%) OF MARION COUNTY COMMUNITY MEMBERS LIVED OUTSIDE OF THE FIVE LARGEST CITIES IN MARION COUNTY. ABOUT 16% OF POLK COUNTY COMMUNITY MEMBERS LIVED OUTSIDE OF ITS LARGEST CITIES. THE COMMUNITY IS GROWING, AGING, AND BECOMING MORE DIVERSE, A TREND THAT IS PREDICTED TO CONTINUE INTO THE FUTURE. POPULATION PROJECTIONS ESTIMATE THAT THERE WILL BE 500,000 COMMUNITY MEMBERS BY 2035. OLDER ADULTS WILL REPRESENT A GREATER PROPORTION OF THE OVERALL POPULATION IN THE FUTURE THAN THEY DO CURRENTLY.EDUCATIONAL ACHIEVEMENT HAS BEEN IMPROVING IN RECENT YEARS AS A HIGHER PERCENTAGE OF COMMUNITY MEMBERS HAVE A HIGH SCHOOL DIPLOMA/GED. 85% OF ADULTS OVER 25 IN MARION COUNTY AND 91% OF ADULTS IN POLK COUNTY HAVE A HIGH SCHOOL DIPLOMA OR GED. HOWEVER, THE PERCENTAGES DROP SIGNIFICANTLY FOR LATINO POPULATIONS WHICH WERE 53% IN MARION COUNTY AND 61% IN POLK COUNTY. EDUCATIONAL ACHIEVEMENT IN MARION COUNTY WAS LOWER THAN POLK AND THE STATE, ESPECIALLY WITH REGARD TO COLLEGE GRADUATES. IN MARION COUNTY 23% OF PEOPLE HAD A BACHELOR'S DEGREE OR HIGHER, COMPARED TO 31% IN POLK. EDUCATIONAL ACHIEVEMENT DIFFERED BY SEX, RACE AND ETHNICITY, GEOGRAPHY, AND DISABILITY STATUS. ABOUT 1 OUT OF 6 CHILDREN WERE FOOD INSECURE IN THIS COMMUNITY AND 87% OF FOOD INSECURE CHILDREN IN MARION AND 76% IN POLK WERE ELIGIBLE FOR SOME FORM OF ASSISTANCE, INCREASING DEMAND ON CHARITABLE SOURCES FOR FOOD. IN MARION, 41% OF COMMUNITY MEMBERS WERE LIVING IN A FOOD DESERT COMPARED TO 18% IN POLK. TO BE CONSIDERED A FOOD DESERT, A CENSUS TRACT MUST BE DESIGNATED AS BOTH LOW-INCOME AND HAVE LOW ACCESS TO SUPERMARKETS OR LARGE GROCERY STORES WHERE HEALTHY FOODS ARE AVAILABLE. IT WAS ALSO DIFFICULT FOR SOME COMMUNITY MEMBERS TO OBTAIN HEALTHY FOODS DUE TO AFFORDABILITY AND LOW ACCESS TO STORES THAT SELL THEM. PART VI, LINE 5: IN ADDITION TO THE WORK DESCRIBED IN THE ABOVE NARRATIVE, SALEM HEALTH HAS A COMMUNITY HEALTH EDUCATION CENTER THAT OFFERS NO AND LOW-COST HEALTH EDUCATION TO THE GENERAL PUBLIC IN THE FORM OF CLASSES, OUTREACH AND ACCESS TO RESEARCH MATERIALS, ONLINE AND IN PRINT. A FULL-TIME LIBRARIAN IS ON STAFF TO ASSIST CLINICIANS WITH THE LATEST RESEARCH AND TREATMENT OPTIONS. A STAFF OF HEALTH EDUCATORS PRESENTS TO THE PUBLIC ON VARIOUS COMMUNITY HEALTH TOPICS ON REQUEST AND ATTENDS WELLNESS FAIRS, PROVIDING BIOMETRICS AND HEALTH INFORMATION. THE SALEM CANCER INSTITUTE OFFERS FREE SCREENINGS SEVERAL TIMES A YEAR FOR VARIOUS CANCERS, INCLUDING BREAST, COLON, LUNG AND SKIN CANCER. STAFF AND CLINICIANS PARTICIPATE IN DOZENS OF HEALTH IMPROVEMENT COMMITTEES, ADDRESSING SOCIAL DETERMINANTS OF HEALTH SUCH AS HOMELESSNESS, FOOD INSECURITY, EDUCATION AND ACCESS TO CARE. FURTHER INFORMATION REGARDING HEALTH PROMOTION CAN BE FOUND IN PART V, SECTION B, LINE 11 NARRATIVE. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 SALEM FREE CLINIC 1300 BROADWAY ST NE SALEM OR 97301 203549992 501(C)3 80000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH BOYS & GIRLS CLUB 1395 SUMMER ST NE SALEM OR 97301 930581470 501(C)3 33000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH CATHOLIC COMMUNITY SERVICES 3737 PORTLAND ROAD NE SALEM OR 97301 930388917 501(C)3 31000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH LIBERTY HOUSE 2685 4TH ST NE SALEM OR 97301 931236936 501(C)3 30750 0 IMPROVE SOCIAL DETERMINATE OF HEALTH THE GATE 1505 MONMOUTH ST INDEPENDENCE OR 97351 202736000 501(C)3 30000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH SALEM KEIZER COALITION 3850 PORTLAND ROAD NE SUITE 260 SALEM OR 97301 651203900 501(C)3 30000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH CHURCH IN THE PARK 2410 TURNER RD NE SALEM OR 97302 853235718 501(C)3 30000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH SALEM PASTORAL COUNSELING CTR 2001 COMMERCIAL ST SE SUITE 200 SALEM OR 97301 930752879 501(C)3 15000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH UNITED WAY OF THE MID-WILLAMETTE VALLEY 455 BLILER AVE NE SALEM OR 97301 930395586 501(C)3 9000 0 IMPROVE SOCIAL DETERMINATE OF HEALTH ALLIED VIDEO PRODUCTIONS 2121 FRONT ST NE SALEM OR 97301 550793914 501(C)3 8355 0 IMPROVE SOCIAL DETERMINATE OF HEALTH GILBERT HOUSE 116 MARION ST NE SALEM OR 97301 930948548 501(C)3 7500 0 IMPROVE SOCIAL DETERMINATE OF HEALTH PSYCHIATRIC CRISIS CENTER PO BOX 14500 SALEM OR 97309 936002307 MARION COUNTY 0 1224435 OVERHEAD COSTS USE OF SPACE ACCESS TO MEDICAL SERVICES 11 CASH ASSISTANCE TO PATIENTS 34100 419246 CASH ASSISTANCE IS PROVIDED TO PATIENTS IN NEED FOR PRESCRIPTIONS, LIFELINE SUPPORT, REHABILITATION AND OTHER URGENT NEEDS. PART I, LINE 2: GRANTS ARE ONLY MADE TO QUALIFIED EXEMPT ORGANIZATIONS. BECAUSE DOCUMENTATION AND AUTHORIZATION IS CAREFULLY EXAMINED BEFORE A GRANT IS GIVEN, AND THE PURPOSES FOR A GRANT ARE KNOWN BEFORE IT IS AWARDED, NO ADDITIONAL FOLLOW UP IS PERFORMED TO FIND OUT HOW THE GRANT WAS USED. X X X X 1 1 0 0 0 0 0 1 0 CHERYL R NESTER WOLFE PRESIDENT & CEO 1003551 0 264799 0 306480 0 25925 0 15523 0 1616278 0 276324 0 JUAN R OYARZUN MD DIR. CARDIOTHORATIC MEDICINE 1232042 0 82123 0 49496 0 50731 0 14364 0 1428756 0 38088 0 NERVIN H FANOUS MD CARDIOTHORACIC SURGEON 1146009 0 75200 0 42280 0 49903 0 9696 0 1323088 0 38305 0 JAMES K PARR EVP OF OPERATIONS & CFO 773768 0 154507 0 52930 0 80418 0 23755 0 1085378 0 50230 0 LEAH M MITCHELL EVP OF OPERATIONS & CIO 774127 0 154507 0 43995 0 80418 0 23355 0 1076402 0 41312 0 MATTHEW S BOLES VP MEDICAL AFFAIRS 628167 0 134027 0 8205 0 61220 0 22900 0 854519 0 5522 0 RALPH A YATES CMO SALEM HEALTH 601798 0 118797 0 65847 0 19825 0 15326 0 821593 0 41899 0 ERIC A LARO GENERAL SURGEON 659184 0 46226 0 3975 0 42221 0 23052 0 774658 0 0 0 JONATHAN H BAUER CHIEF LEGAL OFFICER 571816 0 114425 0 1788 0 57132 0 23478 0 768639 0 0 0 BRANDON H TIEU MD THORACIC SURGEON 609414 0 66983 0 2593 0 39856 0 23052 0 741898 0 0 0 SARAH HORN SR VP & CHIEF NURSING & CLINICAL OPS 514280 0 103006 0 34416 0 62254 0 23479 0 737435 0 32628 0 NICOLE M VANDERHEYDEN MD GENERAL SURGEON HOSPITALIST 554720 0 58260 0 51903 0 55925 0 15984 0 736792 0 40419 0 CHRISTINE G CLARKE MD SHMG CHIEF MEDICAL OFFICER 518717 0 111028 0 4113 0 53569 0 1702 0 689129 0 0 0 KATHERINE A DOBLER VP MEDICAL GROUP 440720 0 88670 0 2683 0 47929 0 21541 0 601543 0 0 0 SHEA M CORUM CHIEF INFORMATION OFFICER 375285 0 74314 0 23474 0 46418 0 23468 0 542959 0 21880 0 JAIME L NICHOLS CHIEF HUMAN RESOURCES OFFICER 360493 0 74452 0 2670 0 51678 0 23438 0 512731 0 0 0 ZENNIA B CENIZA VP CLINICAL OPERATIONS (THRU 10/22) 299606 0 61377 0 102836 0 17965 0 12229 0 494013 0 16938 0 DENISE B HOOVER CHIEF SURGICAL SVCS OFC (THRU 08/22) 221445 0 58094 0 157081 0 31907 0 11417 0 479944 0 91006 0 JENNIFER R FOWLER VP FINANCE 332074 0 66880 0 1446 0 49513 0 23259 0 473172 0 0 0 LEILANI R SLAMA VP COMMUNITY ENGAGEMENT 311673 0 65645 0 26624 0 42087 0 23243 0 469272 0 19834 0 JAMES R BAUER CHIEF DEVELOPMENT OFFICER 317642 0 63864 0 10148 0 39299 0 15512 0 446465 0 0 0 AMIE M WITTENBERG VP CLINICAL OPERATIONS 295016 0 30447 0 635 0 19825 0 23285 0 369208 0 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS WHICH ARE REPORTED IN PART II, COLUMN B(III): DENISE HOOVER: $65,158 ZENNIA CENIZA: $71,517 SOME OF THE HOSPITAL'S INDIVIDUALS RECEIVE DEFERRED COMPENSATION UNDER A 457(F) NONQUALIFIED PLAN. THIS COMPENSATION IS INCLUDED IN COMPENSATION REPORTED IN PART II. THE TOTAL NONQUALIFIED PORTION OF EACH PERSONS DEFERRED COMPENSATION IS: BRANDON TIEU: $23,081 CHRISTINE CLARKE: $33,744 DENISE HOOVER: $12,669 ERIC LARO: $25,456 JAMES PARR: $54,493 JAMES BAUER: $22,524 JAIME NICHOLS: $25,753 JENNIFER FOWLER: $23,588 JONATHAN BAUER: $40,357 JUAN OYARZUN: $30,906 KATHERINE DOBLER: $31,154 LEAH MITCHELL: $54,493 LEILANI SLAMA: $22,262 MATTHEW BOLES: $44,445 NERVIN FANOUS: $30,077 NICOLE VANDERHAYDEN: $30,000 SARAH HORN: $36,329 SHEA CORUM: $26,593 PART I, LINE 7 IN CALENDAR YEAR 2022 THE GOVERNANCE COMMITTEE APPROVED THE DESIGN & PAYOUT OF A MULTI-YEAR RETENTION/BONUS PROGRAM FOR STAFF, LEADERS, & PROVIDERS. IN MARCH 2022 SALEM HEALTH PAID OUT THE EMPLOYEE RECOGNITION & RETENTION PLAN. THE PAYOUT WAS BASED ON A STRUCTURED MODEL SCENARIO. A HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM 521542796 794458EL9 2016-11-01 215638877 SEE PART VI 0 0 0 B HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM 521542796 794458FX2 2019-10-29 321418462 SEE PART VI 0 0 0 A 22815000 216072022 1650101 214380232 41690 1 1 1 1 B 19250000 326721472 2118839 240568021 84034597 16 2023 1 0 0 1 A 0 1 1 1 1 1 0.00500 0.00200 0.00700 0 0 1 B 0 1 1 1 1 1 0.00100 0.00100 0 0 1 A 0 0 1 1 0 0 0 0 1 B 0 1 1 0 0 0 1 BAYERISCHE LANDESBAN 2.000000000000 0 0 1 A 1 B 1 COLUMN A: PART I (F): BOND PROCEEDS WERE EXPENDED TO REFUND THE 2013AB BONDS (ISSUED ON JUNE 27, 2013), TO REFUND THE 2008A BONDS (ISSUED ON OCTOBER 8, 2008), TO REFUND THE 2006A BONDS (ISSUED ON NOVEMBER 15, 2006), AND TO PAY COSTS OF ISSUANCE RELATING TO THE BONDS. PART II, LINE 3 - THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. PART II, LINE 13: SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINES 2(B): THE PORTION OF BOND PROCEEDS USED FOR CURRENT REFUNDING HAS MET THE 6-MONTH EXCEPTION TO REBATE. PART IV, LINES 2(C): BLX INTERIM ARBITRAGE REBATE ANALYSIS DATED 6/21/2021 SHOWS NO REBATE DUE. COLUMN B: PART I (F): BOND PROCEEDS WERE EXPENDED TO REFUND, ON A CURRENT REFUNDING BASIS, THE ISSUER'S VARIABLE RATE REVENUE BONDS (SALEM HEALTH PROJECT), SERIES 2008B ORIGINALLY ISSUED ON NOVEMBER 13, 2008, TO MAKE IMPROVEMENTS TO THE BORROWER'S HEALTH CARE FACILITIES AND TO PAY COSTS OF ISSUANCE ON THE BONDS. PART II, LINE 3 - THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. PART II, LINE 11: INCLUDES A PAYMENT IN CONNECTION WITH THE TERMINATION OF THE INTEREST RATE SWAP RELATED TO THE ISSUER'S VARIABLE RATE REVENUE BONDS (SALEM HEALTH PROJECT), SERIES 2008B. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINES 2(B): THE PORTION OF BOND POCEEDS USED FOR CURRENT REFUNDING HAS MET THE 6-MONTH EXCEPTION TO REBATE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SALEM HEALTH IS SALEM HEALTH HOSPITALS & CLINICS ("SHHC"), A NOT-FOR-PROFIT ENTITY. THE SALEM HEALTH TRUSTEES ARE ELECTED BY SHHC WHO ALSO APPROVES SIGNIFICANT DECISIONS OF THE SALEM HEALTH GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7A THE BYLAWS OF SALEM HEALTH STATE THAT THE TRUSTEES OF SALEM HEALTH SHALL BE ELECTED BY SHHC AT EACH ANNUAL ORGANIZATION MEETING OF THE BOARD OF DIRECTORS OF SHHC, OR IF ANY SUCH ANNUAL MEETING IS NOT HELD, THEN THE TRUSTEES MAY BE ELECTED AT A REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS OF SHHC. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO THE SALEM HEALTH BYLAWS, SHHC SHALL HAVE THE SOLE AND EXCLUSIVE RIGHT TO ACT WITH RESPECT TO THE FOLLOWING AFFAIRS OF SALEM HEALTH: A. APPROVAL OF THE MERGER OR CONSOLIDATION OF SALEM HEALTH WITH ANY OTHER ORGANIZATION OR ENTITY; PROVIDED, HOWEVER, THAT THE BOARD OF TRUSTEES MAY SUBMIT MERGER AND CONSOLIDATION PROPOSALS TO SHHC FOR ITS APPROVAL; B. ELECTION TO DISSOLVE AND WIND UP THE AFFAIRS OF SALEM HEALTH; PROVIDED THAT THE BOARD OF TRUSTEES MAY SUBMIT A DISSOLUTION PROPOSAL TO SHHC FOR ITS APPROVAL; C. SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF SALEM HEALTH; PROVIDED, HOWEVER, THAT THE BOARD OF TRUSTEES MAY SUBMIT PROPOSALS FOR SUCH DISPOSITIONS TO SHHC FOR ITS APPROVAL; D. APPROVAL OF ANNUAL OPERATING CASH AND CAPITAL BUDGETS; E. APPROVAL OF LONG-TERM COMMITMENTS; F. APPROVAL OF LONG-RANGE PLANS; G. APPROVAL OF SPECIAL PROJECTS INVOLVING CAPITAL OR OPERATING EXPENDITURES IN EXCESS OF $1,000,000; AND H. MATERIAL ADDITIONS OR DELETIONS OF SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S ACCOUNTING & FINANCE TEAM WORKS CLOSELY WITH THE OUTSIDE ACCOUNTING FIRM IT ENGAGES TO PREPARE AND REVIEW THE RETURN. THE CONTROLLER AND CFO REVIEW A DRAFT OF THE FORM 990 BEFORE IT IS PRESENTED TO THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES. FINANCE ADMINISTRATION ADDRESSES AND RESPONDS TO QUESTIONS RAISED BY MEMBERS OF THE GOVERNANCE COMMITTEE. AFTER IT IS REVIEWED BY THE GOVERNANCE COMMITTEE, THE FINAL FORM 990 IS FORWARDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS THE SECRETARY OF THE HOSPITAL SHALL SEND TO EACH PERSON WHO IS A TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE, AND TO THOSE EMPLOYEES OF THE HOSPITAL AS THE BOARD MAY DETERMINE, 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, COMMITTEE MEMBER OR EMPLOYEE PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION AT SALEM HEALTH IS DESIGNED TO ALLOW THE ORGANIZATION TO RECRUIT AND RETAIN QUALIFIED SENIOR LEADERS. THE GOVERNANCE COMMITTEE OF THE SALEM HEALTH BOARD OF TRUSTEES, NONE OF WHOM IS A SALEM HEALTH EMPLOYEE, ENGAGES ONE OR MORE INDEPENDENT CONSULTANTS TO PROVIDE MARKET DATA ON CEO COMPENSATION, INCLUDING BENEFITS, FOR THE CEOS AT COMPARABLE ORGANIZATIONS. THIS INFORMATION IS USED BY THE GOVERNANCE COMMITTEE AND BOARD OF TRUSTEES IN THEIR DISCUSSIONS AND DECISIONS ON CEO COMPENSATION. COMPENSATION FOR THE CEO IS REVIEWED ON AN ANNUAL BASIS. THE MOST RECENT REVIEW TOOK PLACE IN SEPTEMBER 2022. THE COMPENSATION DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE AND BOARD MINUTES FOR THIS MEETING. ONE OR MORE INDEPENDENT CONSULTANTS ARE ALSO RETAINED TO REVIEW EXECUTIVE COMPENSATION SEPARATE FROM THE CEO. THE CEO, IN CONJUNCTION WITH THE INDEPENDENT CONSULTANTS, ENSURES THAT EACH EXECUTIVE'S COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. THE CEO ALSO PROVIDES INFORMATION TO THE BOARD GOVERNANCE COMMITTEE ON THE LEVELS OF EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE ON THE HOSPITAL WEBSITE. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME 525,634. CHANGE IN NET BENEFICIAL INTEREST IN FOUNDATION 639,113. CHANGE IN NET BENEFIT COST -2,269,073. SALEM HEALTH WEST VALLEY 525 SOUTHEAST WASHINGTON ST DALLAS OR 97339 431960221 HOSPITAL OR 501(C)(3) LINE 3 SHHC 0 WILLAMETTE VALLEY INSURANCE COMPANY 745 FORT STREET HONOLULU HI 96813 201836190 INSURANCE HI 501(C)(3) LINE 12A, I SHHC 0 SALEM HEALTH FOUNDATION 890 OAK STREET SALEM OR 97301 237002687 SUPPORT SH OR 501(C)(3) LINE 7 SHHC 0 SALEM HEALTH HOSPITALS & CLINICS 890 OAK STREET SALEM OR 97301 930823471 LEASES LAND OR 501(C)(3) LINE 12A, I N/A 0 SALEM HEALTH PROFESSIONAL SERVICES 890 OAK STREET SALEM OR 97301 753175249 BILLING OR 501(C)(3) LINE 12A, I SHHC 0 WEST VALLEY HOSPITAL FOUNDATION 525 SOUTHEAST WASHINGTON ST DALLAS OR 97339 931298564 SUPPORT SHWV OR 501(C)(3) LINE 12A, I SHHC 0 SALEM AMBULATORY SURGERY CENTER LLC 700 BELLEVUE ST SE STE 200 SALEM OR 97301 SURGERY CENTER OR N/A -2197864 -1961550 0 0 0.51000 WILLAMETTE SURGERY CENTER LLC 1445 STATE STREET SALEM OR 97301 SURGERY CENTER OR SALEM HEALTH 2422463 1883208 0 0 0.54200 WSC BUILDING GROUP LLC 1445 STATE STREET SALEM OR 97301 SURGERY CENTER REAL ESTATE OR SALEM HEALTH -196527 7244803 0 0 0.51000 OREGON HEALTHCARE ENTERPRISES INC TTTE 1 4000 KRUSE WAY PL BLDG 2 STE 100 LAKE OSWEGO OR 97035 456525337 TAX TRUST PROGRAM OR N/A T 157247 0.06850 0 PACIFIC MEDICAL CONDOMINIUM UNIT OWNERS 890 OAK STREET SALEM OR 97301 454353791 OWNERS ASSN OR SALEM HEALTH C 1039571 1841177 0.71590 0 1 0 1 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1