SAMARITAN HEALTH SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SAMARITAN HEALTH SERVICES INC (EIN 93-0951989)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-10
- IRS object ID
- 202233149349303073
- Schema version
- 2021v4.2
- 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 C
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-10T10:48:07-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930951989 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMA | BusinessNameControlTxt |
| Phone | 5417684857 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | CO SHS ACCOUNTING PO BOX 3000 | AddressLine1Txt |
| City | CORVALLIS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 973393000 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL B SMITH | PersonNm |
| Person Title | SVP / CFO | PersonTitleTxt |
| Phone | 5417684857 | PhoneNum |
| Signature | 2022-11-07 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DANIEL | PersonFirstNm |
| Person Last | SMITH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUGLAS BOYSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 NW SAMARITAN DR | AddressLine1Txt |
| City | CORVALLIS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97330 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $319,473,650 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SAMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO ENHANCE COMMUNITY HEALTH THROUGH QUALITY SERVICES ACROSS A CONTINUUM OF CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 1420 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $2,249,211 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $217,662 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,113,405 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,330,821 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $231,936,557 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $266,269,152 | CYProgramServiceRevenueAmt |
| PY Investment Income | $112,676 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,387,865 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,473,588 | PYOtherRevenueAmt |
| CY Other Revenue | $2,818,275 | CYOtherRevenueAmt |
| PY Total Revenue | $236,636,226 | PYTotalRevenueAmt |
| CY Total Revenue | $271,806,113 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $109,416 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $100,267 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $95,858,685 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $127,943,242 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $21,798 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $2,588 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $2,144,766 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $131,967,058 | PYOtherExpensesAmt |
| CY Other Expenses | $145,056,264 | CYOtherExpensesAmt |
| PY Total Expenses | $227,956,957 | PYTotalExpensesAmt |
| CY Total Expenses | $273,102,361 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,679,269 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,296,248 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $432,777,505 | TotalAssetsBOYAmt |
| Total Assets EOY | $420,076,379 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $376,917,271 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $365,560,743 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $55,860,234 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $54,515,636 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SAMARITAN HEALTH SERVICES (SHS) IS THE PARENT COMPANY OF A REGIONAL NETWORK OF HOSPITALS, PHYSICIANS AND SENIOR CARE FACILITIES. (CONTINUED ON SCHEDULE O)(CONTINUED FROM PART III) THE NETWORK, FORMED IN THE LATE 1990'S, SERVES APPROXIMATELY 290,000 RESIDENTS IN LINN, BENTON, LINCOLN AND PORTIONS OF POLK AND MARION COUNTIES IN OREGON. IT IS LOCALLY OWNED, AND ITS BOARDS OF DIRECTORS INCLUDE HOSPITAL LEADERS, PHYSICIANS AND COMMUNITY REPRESENTATIVES. SHS PROVIDES HEALTHCARE SERVICES REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, DISABILITY OR AGE. THE MISSION OF SHS IS "BUILDING HEALTHIER COMMUNITIES TOGETHER." THE COLLECTIVE VISION OF THE SHS SYSTEM IS TO SERVE OUR COMMUNITIES WITH PRIDE (PASSION, RESPECT, INTEGRITY, DEDICATION, AND EXCELLENCE). SHS SEEKS TO BE THE FIRST CHOICE OF CONSUMERS IN THE REGION AND TO LEAD COLLABORATIVE EFFORTS AMONG THOSE WHO SHARE SIMILAR GOALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $238,072,811 | ExpenseAmt |
| Revenue | $265,301,582 | RevenueAmt |
| Desc | AS THE PARENT ORGANIZATION, SHS PROVIDES ADMINISTRATIVE AND OTHER SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS, SUCH AS PATIENT BILLING, INFORMATION SERVICES, ACCOUNTING, AND EMPLOYEE RECRUITMENT. SHS SPONSORS A HEALTH PLAN THAT PROVIDES MEDICAL, DENTAL, AND PHARMACY BENEFITS TO EMPLOYEES OF SHS AND ITS AFFILIATES. AS A SYSTEM, SHS LOOKS CAREFULLY AT LOCAL HEALTH CARE NEEDS AND GIVES THOUGHTFUL CONSIDERATION TO THE MOST EFFECTIVE WAYS TO MEET THOSE NEEDS. THE RESULT IS A RICH MIX OF LOCAL AND CENTRALIZED REGIONAL SERVICES, WHICH PROVIDE HIGH VALUE AND EXCELLENT HEALTH CARE FOR PEOPLE AT ALL STAGES OF THEIR LIVES.SAMARITAN HEALTH SERVICES (SHS) HAS POLICIES THAT PROVIDE FOR SERVING THOSE WITHOUT THE ABILITY TO PAY FOR TREATMENT. THE POLICIES ESTABLISH CRITERIA BASED ON THE INCOME OF THE PERSON RESPONSIBLE FOR THE BILL AND COLLECTIONS ARE AT AMOUNTS LESS THAN ITS ESTABLISHED RATES ON A SLIDING SCALE DOWN TO NO PAYMENT AT ALL. IN 2021 SHS PROVIDED SERVICES THAT BENEFITED THE POOR AND OTHERS IN THE COMMUNITIES IT SERVED. IN ADDITION TO THE GRANTS SHOWN ON LINE 4B, SHS INCURRED $2,755,018 OF COMMUNITY BENEFIT COSTS, INCLUDING HEALTH PROFESSION EDUCATION, COMMUNITY BUILDING ACTIVITIES, AND RESEARCH. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $100,267 | ExpenseAmt |
| Grant | $100,267 | GrantAmt |
| Desc | GRANTS AND ASSISTANCE PROVIDED BY SAMARITAN HEALTH SERVICES TO VARIOUS ORGANIZATIONS INCLUDING GRANTS TO ASSIST RESIDENTS IN BENTON, AND LINN COUNTIES. SEE PART IX, LINES 1 AND 2 AND RELATED SCHEDULE I FOR MORE DETAILS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $238,173,078 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | Yes (1) | InvestTaxExemptBondsInd |
| Escrow Account | Yes (1) | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1432 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1420 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (1) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5417684857 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3000 | AddressLine1Txt |
| City | CORVALLIS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 973393000 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (44 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| JUDY LIST | ||||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BOB ADAMS | ||||||||||
| BOARD SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| RANDY SPRINGER | ||||||||||
| BOARD TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MILTON MORAN | ||||||||||
| BOARD CHAIR ELECT | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LOREN ROTH | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CHARLES MOURADIAN | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JIM DENHAM | ||||||||||
| BOARD MEMBER | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||||
| NANCY SEIFERT | ||||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD KENYON | ||||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| TROY GARRETT MD | ||||||||||
| BOARD MEMBER / PHYSICIAN | 1.00 | 39.00 | Yes (X) | $0 | $241,210 | $22,388 | ||||
| REVEREND WILLIAM MCCARTHY | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LESLIE PLISKIN MD | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PAUL DASKALOS DO | ||||||||||
| BOARD MEMBER / PHYSICIAN | 1.00 | 39.00 | Yes (X) | $0 | $484,779 | $60,085 | ||||
| STUART PRITCHARD | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JUNE CHRISMAN | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RALPH BREITENSTEIN MD | ||||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DOUGLAS BOYSEN | ||||||||||
| PRESIDENT & CEO | 33.00 | 7.00 | Yes (X) | $1,252,525 | $0 | $62,524 | ||||
| DANIEL SMITH | ||||||||||
| SVP / CFO | 23.00 | 17.00 | Yes (X) | $585,596 | $0 | $62,069 | ||||
| ROBERT TURNGREN MD | ||||||||||
| SVP / CHIEF PHYSICIAN EXEC | 39.00 | 1.00 | $592,971 | $0 | $55,356 | Yes (X) | ||||
| KELLEY KAISER | ||||||||||
| SVP / CAO | 35.00 | 5.00 | $479,877 | $0 | $60,358 | Yes (X) | ||||
| JOSEPH CAHILL | ||||||||||
| VP CEO MVH | 1.00 | 39.00 | $419,694 | $0 | $48,825 | Yes (X) | ||||
| LESLEY OGDEN MD | ||||||||||
| VP CEO NLH / CEO SPCH | 1.00 | 39.00 | $460,120 | $0 | $52,171 | Yes (X) | ||||
| ROBERT POWER TERM FEB 2021 | ||||||||||
| VP CIO | 40.00 | $155,826 | $0 | $16,797 | Yes (X) | |||||
| KIRK GERNER | ||||||||||
| VP INNOVATIONS / STRATEGIC DEV | 40.00 | $450,330 | $0 | $54,611 | Yes (X) | |||||
| DANIEL KETERI | ||||||||||
| VP CEO SAGH | 1.00 | 39.00 | $425,033 | $0 | $57,213 | Yes (X) | ||||
| JULIE MANNING | ||||||||||
| VP MKTG / PR & COMMUNITY HLTH | 32.00 | $268,426 | $0 | $51,737 | Yes (X) | |||||
| GAIL WORDEN-ACREE | ||||||||||
| VP HUMAN RESOURCES | 40.00 | $303,317 | $0 | $62,801 | Yes (X) | |||||
| GLEN CUNNINGHAM | ||||||||||
| VP POPULATION HEALTH SERVICES | 40.00 | $228,417 | $0 | $52,050 | Yes (X) | |||||
| BRUCE BUTLER | ||||||||||
| VP CEO HEALTH PLANS | 20.00 | 20.00 | $469,591 | $0 | $41,616 | Yes (X) | ||||
| TYLER JACOBSEN | ||||||||||
| VP GENERAL COUNSEL | 40.00 | $277,904 | $0 | $64,900 | Yes (X) | |||||
| SHILOH ERVEN | ||||||||||
| VP SMG ADMINISTRATION | 40.00 | $199,150 | $0 | $42,389 | Yes (X) | |||||
| LAURA HENNUM | ||||||||||
| VP CEO GSRMC | 1.00 | 39.00 | $456,502 | $0 | $45,946 | Yes (X) | ||||
| MARGARET MIKULA MD | ||||||||||
| VP CHIEF QUAL OFFICER | 40.00 | $485,522 | $0 | $45,665 | Yes (X) | |||||
| BRADLEY WAKEFIELD | ||||||||||
| VP SMG COO | 40.00 | $396,033 | $0 | $60,346 | Yes (X) | |||||
| PANKAJ SAPRA | ||||||||||
| SVP / CIO (START APR 2021) | 40.00 | $298,885 | $0 | $25,133 | Yes (X) | |||||
| JANET MCGUIRE | ||||||||||
| VP REVENUE CYCLE | 40.00 | $271,320 | $0 | $16,957 | Yes (X) | |||||
| NANCY FRY | ||||||||||
| VP FINANCE | 40.00 | $212,666 | $0 | $28,797 | Yes (X) | |||||
| DAVID ZARKOU DPM | ||||||||||
| SENIOR MEDICAL DIRECTOR | 40.00 | $396,871 | $0 | $61,528 | Yes (X) | |||||
| BARRY SMITH MD | ||||||||||
| SENIOR MEDICAL DIRECTOR | 40.00 | $413,929 | $0 | $47,538 | Yes (X) | |||||
| KEVIN EWANCHYNA MD | ||||||||||
| VP CHIEF MEDICAL OFFICER SHPO | 40.00 | $427,861 | $0 | $61,793 | Yes (X) | |||||
| KRISTY JESSOP MD | ||||||||||
| SENIOR MEDICAL DIRECTOR | 40.00 | $363,200 | $0 | $47,055 | Yes (X) | |||||
| BRENT GODEK MD | ||||||||||
| SENIOR MEDICAL DIRECTOR | 40.00 | $363,187 | $0 | $47,499 | Yes (X) | |||||
| BECKY PAPE | ||||||||||
| QUALITY IMPROVE / REVIEW COORD | 10.00 | $106,638 | $109,803 | $28,225 | Yes (X) | |||||
| RYAN COMBS | ||||||||||
| VP OPERATIONS MVH | 0.00 | 40.00 | $0 | $288,243 | $63,333 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $10,761,391 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,124,035 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,447,705 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 225 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | STAFFING SERVICES | $5,777,543 |
| HEMATOLOGY ONCOLOGY OF SALEM LLP | |||||
| 875 OAK ST SE STE 4030 | SALEM | OR | 97301 | CLINICAL SERVICES | $4,501,352 |
| GREENBERRY CONSTRUCTION LLC | |||||
| 2273 NW PROFESSIONAL DR SUITE 200 | CORVALLIS | OR | 97330 | CONSTRUCTION | $4,140,089 |
| HGS AXISPOINT HEALTH LLC | |||||
| PO BOX 660367 | DALLAS | TX | 752660367 | CARE MGMT SERVICES | $4,089,360 |
| COGNIZANT WORLD | |||||
| 24721 NETWORK PLACE | CHICAGO | IL | 606731247 | IT CONSULTING SERVICES | $3,458,818 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 144 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $100,097 | RelatedOrganizationsAmt |
| Government Grants | $510,754 | GovernmentGrantsAmt |
| All Other Contributions | $719,970 | AllOtherContributionsAmt |
| Total Contributions | $1,330,821 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| SUPPORT SERVICE FEES | 561000 | $161,592,957 | $161,592,957 | |
| EMPL HEALTH PLAN PREM | 525100 | $102,472,816 | $102,472,816 | |
| FITNESS CENTER REVENUE | 713940 | $1,487,855 | $554,088 | $933,767 |
| DURABLE MEDICAL EQUIP | 446199 | $286,769 | $252,966 | $33,803 |
| OTH PROG SVC REVENUE | 900099 | $226,439 | $226,439 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $202,316 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $202,316 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $266,269,152 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,384,808 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $63,000 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,321,808 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,190,227 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,500,593 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,689,634 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,689,634 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $90,000 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,599,634 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $46,050,001 | SecuritiesAmt |
| Other | $120,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $46,047,458 | SecuritiesAmt |
| Other | $119,486 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,543 | SecuritiesAmt |
| Other | $514 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,057 | TotalRevenueColumnAmt |
| Exclusion | $3,057 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|
| JOINT VENTURES | 900099 | $593,361 | $593,361 |
| GROUP PURCHASING | 561499 | $282,054 | $282,054 |
| OCCUPANCY SERVICES | 561700 | $253,226 | $253,226 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,128,641 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $271,806,113 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $265,301,582 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,249,211 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,924,499 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,267 | TotalAmt |
| Program Services | $100,267 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,697,960 | TotalAmt |
| Management And General | $9,697,960 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,773,768 | TotalAmt |
| Program Services | $70,378,199 | ProgramServicesAmt |
| Management And General | $14,052,808 | ManagementAndGeneralAmt |
| Fundraising | $1,342,761 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,002,675 | TotalAmt |
| Program Services | $4,196,159 | ProgramServicesAmt |
| Management And General | $736,174 | ManagementAndGeneralAmt |
| Fundraising | $70,342 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,716,642 | TotalAmt |
| Program Services | $17,376,767 | ProgramServicesAmt |
| Management And General | $3,048,580 | ManagementAndGeneralAmt |
| Fundraising | $291,295 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,752,197 | TotalAmt |
| Program Services | $5,663,628 | ProgramServicesAmt |
| Management And General | $993,627 | ManagementAndGeneralAmt |
| Fundraising | $94,942 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,916 | TotalAmt |
| Program Services | $1,916 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,435 | TotalAmt |
| Management And General | $504,435 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $387,723 | TotalAmt |
| Management And General | $387,723 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,124 | TotalAmt |
| Program Services | $81,124 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,588 | TotalAmt |
| Fundraising | $2,588 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,390 | TotalAmt |
| Program Services | $24,195 | ProgramServicesAmt |
| Management And General | $24,195 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,721,756 | TotalAmt |
| Program Services | $9,634,006 | ProgramServicesAmt |
| Management And General | $56,750 | ManagementAndGeneralAmt |
| Fundraising | $31,000 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $869,536 | TotalAmt |
| Program Services | $852,824 | ProgramServicesAmt |
| Management And General | $14,162 | ManagementAndGeneralAmt |
| Fundraising | $2,550 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,220,469 | TotalAmt |
| Program Services | $8,751,415 | ProgramServicesAmt |
| Management And General | $409,527 | ManagementAndGeneralAmt |
| Fundraising | $59,527 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,118,329 | TotalAmt |
| Program Services | $10,871,096 | ProgramServicesAmt |
| Management And General | $247,233 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,358,281 | TotalAmt |
| Program Services | $2,230,349 | ProgramServicesAmt |
| Management And General | $95,070 | ManagementAndGeneralAmt |
| Fundraising | $32,862 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,910 | TotalAmt |
| Program Services | $194,438 | ProgramServicesAmt |
| Management And General | $3,554 | ManagementAndGeneralAmt |
| Fundraising | $918 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,573 | TotalAmt |
| Program Services | $258,417 | ProgramServicesAmt |
| Management And General | $1,429 | ManagementAndGeneralAmt |
| Fundraising | $1,727 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,638,011 | TotalAmt |
| Program Services | $940,150 | ProgramServicesAmt |
| Management And General | $697,861 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,066,981 | TotalAmt |
| Program Services | $12,785,284 | ProgramServicesAmt |
| Management And General | $281,324 | ManagementAndGeneralAmt |
| Fundraising | $373 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,136,410 | TotalAmt |
| Program Services | $2,525,540 | ProgramServicesAmt |
| Management And General | $610,870 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CLAIM FEES | $89,481,718 | $89,481,718 | ||
| PURCHASED SERVICES | $1,514,454 | $923,625 | $395,687 | $195,142 |
| DUES, TAXES, & LICENSES | $847,160 | $302,873 | $525,548 | $18,739 |
| MEDICAL SUPPLIES | $400,759 | $400,759 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,329 | TotalAmt |
| Program Services | $198,329 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,102,361 | TotalAmt |
| Program Services | $238,173,078 | ProgramServicesAmt |
| Management And General | $32,784,517 | ManagementAndGeneralAmt |
| Fundraising | $2,144,766 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000 | BOYAmt |
| EOY | $800 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $268,545,299 | BOYAmt |
| EOY | $253,969,194 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $774,666 | BOYAmt |
| EOY | $859,990 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,924 | BOYAmt |
| EOY | $20,924 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,498,107 | BOYAmt |
| EOY | $1,219,191 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,219 | BOYAmt |
| EOY | $189,620 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,078,399 | BOYAmt |
| EOY | $8,274,860 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $245,424,169 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $131,433,397 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,331,543 | BOYAmt |
| EOY | $113,990,772 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,474,714 | BOYAmt |
| EOY | $22,432,068 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,923 | BOYAmt |
| EOY | $171,923 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,760,711 | BOYAmt |
| EOY | $18,947,037 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $432,777,505 | BOYAmt |
| EOY | $420,076,379 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,342,050 | BOYAmt |
| EOY | $55,502,487 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $768,511 | BOYAmt |
| EOY | $650,348 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,991,550 | BOYAmt |
| EOY | $166,849,305 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,159,571 | BOYAmt |
| EOY | $37,339,168 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,655,589 | BOYAmt |
| EOY | $105,219,435 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $376,917,271 | BOYAmt |
| EOY | $365,560,743 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,860,234 | BOYAmt |
| EOY | $54,515,636 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,860,234 | BOYAmt |
| EOY | $54,515,636 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $432,777,505 | BOYAmt |
| EOY | $420,076,379 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,296,248 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$661,906 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $613,556 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 5 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (5 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| ALBANY GEN HOSP | ||||
| 930110095 | 3 | Yes (1) | $0 | $29,271,705 |
| GOOD SAM HOSP | ||||
| 930391573 | 3 | Yes (1) | $0 | $62,683,203 |
| MID-VALLEY HC | ||||
| 930396847 | 3 | Yes (1) | $0 | $17,564,662 |
| N LINCOLN HOSP | ||||
| 931305493 | 3 | Yes (1) | $0 | $7,634,176 |
| SAM PAC HLTH SVCS | ||||
| 931329784 | 3 | Yes (1) | $0 | $15,000,361 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 5 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $132,154,107 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | Yes (1) | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Parent Supported Org | Yes (X) | ParentSupportedOrgInd |
| Appoint Elect Majority Officer | Yes (1) | AppointElectMajorityOfficerInd |
| Exercise Direction Policies | Yes (1) | ExerciseDirectionPoliciesInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 12G | AS THE PARENT ORGANIZATION, SHS PROVIDES ADMINISTRATIVE AND OTHER SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS, SUCH AS PATIENT BILLING, INFORMATION SERVICES, ACCOUNTING, AND EMPLOYEE RECRUITMENT. THE AMOUNTS SHOWN ON PART I, LINE G REPRESENT THE VALUE OF THESE SERVICES ALLOCATED TO THE SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION A, LINE 6 | SEVERAL ORGANIZATION(S) WERE GIVEN GRANTS TO SUPPORT THEIR EXEMPT FUNCTIONS. SEE SCHEDULE I PART II FOR MORE DETAILS. |
| PART IV, SECTION D, LINE 1 | AS THE PARENT COMPANY AND SOLE CORPORATE MEMBER OF ALL SUPPORTED ORGANIZATIONS, SHS PROVIDES MONTHLY FINANCIAL STATEMENTS SHOWING THE AMOUNT OF SUPPORT PROVIDED TO EACH OF ITS SUPPORTED ORGANIZATIONS. THE EXECUTIVE LEADERSHIP OF ALL SUPPORTED ORGANIZATIONS IS PRESENT FOR THE FINAL REVIEW OF THE FORM 990 WITH THE SHS BOARD OF DIRECTORS. IN ADDITION, THIS SAME LEADERSHIP TEAM IS PRESENT AT BOARD MEETINGS WHERE CHANGES TO GOVERNING DOCUMENTS ARE PROPOSED AND APPROVED. |
| PART IV, SECTION D, LINE 3 | THE SHS BOARD IS COMPOSED OF MEMBERS FROM THE SUPPORTED ORGANIZATIONS. |
| PART IV, SECTION E, LINE 3A | THE PARENT CORPORATION (SHS) HAS SEVERAL RESERVED POWERS PER THE BYLAWS OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I OF SCHEDULE A. FOR EXAMPLE, THE ELECTION AND REMOVAL OF DIRECTORS MUST BE APPROVED BY THE PARENT CORPORATION (SHS). |
| PART IV, SECTION E, LINE 3B | THE PARENT CORPORATION (SHS) HAS SEVERAL RESERVED POWERS PER THE BYLAWS OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I OF SCHEDULE A. THESE INCLUDE THE APPROVAL OF INDEBTEDNESS, THE APPROVAL OF ACQUISITIONS AND MERGERS, SALES AND TRANSFERS OF ASSETS, APPROVAL OF CAPITAL BUDGETS, AND ANY CHANGES TO THE ORGANIZATIONAL DOCUMENTS, AMONG OTHERS. |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $56,903 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $24,221 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $81,124 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LINE 1F: THE FILING ORGANIZATION MAINTAINS MEMBERSHIPS IN THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND OREGON ASSOCIATION OF HOSPITALS AND HEALTHCARE SYSTEMS (OAHHS). DURING TAX YEAR 2021, THE FILING ORGANIZATION PAID MEMBERSHIP DUES TO OAHHS AND AHA OF $219,201 AND $108,974 RESPECTIVELY. 12.80% OF OAHHS DUES AND 26.47% OF AHA DUES WENT FOR LOBBYING PURPOSES. THUS, THE FILING ORGANIZATION MADE INDIRECT LOBBYING EXPENDITURES OF $56,903 THROUGH ITS MEMBERSHIP DUES. PAID STAFF HAD DIRECT CONTACT WITH GOVERNMENT OFFICIALS REGARDING THE FOLLOWING TOPICS: KEY HEALTH POLICY AREAS SUCH AS; INVESTMENTS IN BEHAVIORAL HEALTH SERVICES, EXPANDING HEALTH COVERAGE, SOCIAL DETERMINANTS OF HEALTH, HOUSING, MENTAL HEALTH PARITY, HEALTH CARE INTERPRETERS, MERGERS AND ACQUISITIONS, SURGICAL TECHNOLOGIST APPRENTICESHIP, NURSE STAFFING, TELEHEALTH, CLINICAL LAB RESULTS SHARING, COMMUNITY INFORMATION EXCHANGE AND OTHERS. 24,221 OF THE PAID STAFF'S SALARY AND BENEFITS WAS ALLOCATED TO THESE ACTIVITIES BASED ON THEIR TIME SPENT WITH GOVERNMENT OFFICIALS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $3,665,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $17,218,352 | OtherCostOrOtherBasisAmt |
| Book Value | $20,883,352 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $21,220,093 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $75,270,449 | OtherCostOrOtherBasisAmt |
| Depreciation | $35,190,103 | DepreciationAmt |
| Book Value | $61,300,439 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,306,989 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,996,452 | DepreciationAmt |
| Book Value | $1,310,537 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,119,590 | OtherCostOrOtherBasisAmt |
| Depreciation | $91,489,856 | DepreciationAmt |
| Book Value | $18,629,734 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,623,696 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,756,986 | DepreciationAmt |
| Book Value | $11,866,710 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $113,990,772 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $22,432,068 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $22,432,068 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| LIABILITY FOR UNPAID MEDICAL CLAIMS | $8,012,192 |
| TENANT DEPOSITS | $150,000 |
| ACCRUED INTEREST | $1,133,876 |
| OTHER LIABILITIES | $16,834,378 |
| ACCOUNTS PAYABLE - AFFILIATES | $79,088,989 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $105,219,435 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FOOTNOTE DISCLOSURE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE THE SHS' MANAGEMENT TO EVALUATE TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF SHS 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 SHS AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SHS IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. SHS' MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2018. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| UNITED WAY OF BENTON & LINCOLN COUNTIES | ||||||||
| PO BOX 2499 | CORVALLIS | OR | 97339 | 936013898 | 501(C)(3) | $15,000 | $0 | FUNDING TO SUPPORT COMMUNITY NEEDS IN BENTON, LINN, AND LINCOLN COUNTIES |
| LINN BENTON COMMUNITY COLLEGE FOUNDATION | ||||||||
| 6500 PACIFIC BLVD SW | ALBANY | OR | 97321 | 237212073 | 501(C)(3) | $37,500 | $0 | FUNDING FOR CHILDCARE SUPPORT SERVICES |
| BENTON COUNTY | ||||||||
| PO BOX 964 | CORVALLIS | OR | 97339 | 936002285 | GOV'T | $37,767 | $0 | FUNDING FOR A REGIONAL HEALTH ASSESSMENT COLLABORATION |
| CASA LATINOS UNIDOS DE BENTON COUNTY | ||||||||
| 1435 SW 35TH ST | CORVALLIS | OR | 97333 | 263639798 | 501(C)(3) | $10,000 | $0 | FUNDING TO SUPPORT THE LATINO COMMUNITIES OF LINN AND BENTON COUNTIES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AGENCIES IN THE COMMUNITY ARE INVITED TO SUBMIT GRANT PROPOSALS THROUGH AN APPLICATION PROCESS. A COMMITTEE REVIEWS THE APPLICATIONS TO DETERMINE IF THE FUNDS REQUESTED WILL BE USED TO ADDRESS THE ORGANIZATION'S ESTABLISHED COMMUNITY HEALTH PRIORITIES, IDENTIFIED NEEDS, AND SUPPORTS THE ORGANIZATION'S MISSION. ONCE APPROVED AND FUNDED, AGENCIES MUST SUBMIT A COMPLETE ANNUAL REPORT DESCRIBING HOW THE FUNDS WERE USED, THE NUMBER OF CLIENTS SERVED, AND HOW OUTCOMES WERE ACHIEVED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | Yes (1) | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (30 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS BOYSEN | ||||||||||||||
| PRESIDENT & CEO | $968,319 | $0 | $236,288 | $0 | $47,918 | $0 | $23,288 | $0 | $39,236 | $0 | $1,315,049 | $0 | $0 | $0 |
| ROBERT TURNGREN MD | ||||||||||||||
| SVP / CHIEF PHYSICIAN EXEC | $468,093 | $0 | $91,343 | $0 | $33,535 | $0 | $23,288 | $0 | $32,068 | $0 | $648,327 | $0 | $0 | $0 |
| DANIEL SMITH | ||||||||||||||
| SVP / CFO | $449,329 | $0 | $86,742 | $0 | $49,525 | $0 | $23,288 | $0 | $38,781 | $0 | $647,665 | $0 | $0 | $0 |
| PAUL DASKALOS DO | ||||||||||||||
| BOARD MEMBER / PHYSICIAN | $0 | $475,129 | $0 | $7,339 | $0 | $2,311 | $0 | $23,288 | $0 | $36,797 | $0 | $544,864 | $0 | $0 |
| KELLEY KAISER | ||||||||||||||
| SVP / CAO | $396,801 | $0 | $80,801 | $0 | $2,275 | $0 | $23,288 | $0 | $37,070 | $0 | $540,235 | $0 | $0 | $0 |
| MARGARET MIKULA MD | ||||||||||||||
| VP CHIEF QUAL OFFICER | $423,503 | $0 | $35,833 | $0 | $26,186 | $0 | $6,946 | $0 | $38,719 | $0 | $531,187 | $0 | $0 | $0 |
| LESLEY OGDEN MD | ||||||||||||||
| VP CEO NLH / CEO SPCH | $358,818 | $0 | $66,110 | $0 | $35,192 | $0 | $23,288 | $0 | $28,883 | $0 | $512,291 | $0 | $0 | $0 |
| BRUCE BUTLER | ||||||||||||||
| VP CEO HEALTH PLANS | $389,835 | $0 | $73,903 | $0 | $5,853 | $0 | $23,288 | $0 | $18,328 | $0 | $511,207 | $0 | $0 | $0 |
| KIRK GERNER | ||||||||||||||
| VP INNOVATIONS / STRATEGIC DEV | $286,246 | $0 | $40,791 | $0 | $123,293 | $0 | $23,288 | $0 | $31,323 | $0 | $504,941 | $0 | $0 | $0 |
| LAURA HENNUM | ||||||||||||||
| VP CEO GSRMC | $417,351 | $0 | $35,448 | $0 | $3,703 | $0 | $6,905 | $0 | $39,041 | $0 | $502,448 | $0 | $0 | $0 |
| KEVIN EWANCHYNA MD | ||||||||||||||
| VP CHIEF MEDICAL OFFICER SHPO | $392,544 | $0 | $4,767 | $0 | $30,550 | $0 | $23,288 | $0 | $38,505 | $0 | $489,654 | $0 | $0 | $0 |
| DANIEL KETERI | ||||||||||||||
| VP CEO SAGH | $358,139 | $0 | $63,345 | $0 | $3,549 | $0 | $17,488 | $0 | $39,725 | $0 | $482,246 | $0 | $0 | $0 |
| JOSEPH CAHILL | ||||||||||||||
| VP CEO MVH | $332,024 | $0 | $58,693 | $0 | $28,977 | $0 | $23,288 | $0 | $25,537 | $0 | $468,519 | $0 | $0 | $0 |
| BARRY SMITH MD | ||||||||||||||
| SENIOR MEDICAL DIRECTOR | $375,781 | $0 | $37,250 | $0 | $898 | $0 | $23,288 | $0 | $24,250 | $0 | $461,467 | $0 | $0 | $0 |
| DAVID ZARKOU DPM | ||||||||||||||
| SENIOR MEDICAL DIRECTOR | $346,863 | $0 | $34,414 | $0 | $15,594 | $0 | $23,288 | $0 | $38,240 | $0 | $458,399 | $0 | $0 | $0 |
| BRADLEY WAKEFIELD | ||||||||||||||
| VP SMG COO | $321,031 | $0 | $65,602 | $0 | $9,400 | $0 | $23,288 | $0 | $37,058 | $0 | $456,379 | $0 | $0 | $0 |
| BRENT GODEK MD | ||||||||||||||
| SENIOR MEDICAL DIRECTOR | $329,996 | $0 | $32,448 | $0 | $743 | $0 | $23,288 | $0 | $24,211 | $0 | $410,686 | $0 | $0 | $0 |
| KRISTY JESSOP MD | ||||||||||||||
| SENIOR MEDICAL DIRECTOR | $330,244 | $0 | $32,448 | $0 | $508 | $0 | $23,288 | $0 | $23,767 | $0 | $410,255 | $0 | $0 | $0 |
| GAIL WORDEN-ACREE | ||||||||||||||
| VP HUMAN RESOURCES | $215,202 | $0 | $42,757 | $0 | $45,358 | $0 | $23,288 | $0 | $39,513 | $0 | $366,118 | $0 | $0 | $0 |
| RYAN COMBS | ||||||||||||||
| VP OPERATIONS MVH | $0 | $252,849 | $0 | $23,613 | $0 | $11,781 | $0 | $23,288 | $0 | $40,045 | $0 | $351,576 | $0 | $0 |
| TYLER JACOBSEN | ||||||||||||||
| VP GENERAL COUNSEL | $232,046 | $0 | $33,420 | $0 | $12,438 | $0 | $23,145 | $0 | $41,755 | $0 | $342,804 | $0 | $0 | $0 |
| PANKAJ SAPRA | ||||||||||||||
| SVP / CIO (START APR 2021) | $262,979 | $0 | $35,000 | $0 | $906 | $0 | $0 | $0 | $25,133 | $0 | $324,018 | $0 | $0 | $0 |
| JULIE MANNING | ||||||||||||||
| VP MKTG / PR & COMMUNITY HLTH | $200,329 | $0 | $45,403 | $0 | $22,694 | $0 | $21,462 | $0 | $30,275 | $0 | $320,163 | $0 | $0 | $0 |
| JANET MCGUIRE | ||||||||||||||
| VP REVENUE CYCLE | $264,974 | $0 | $3,834 | $0 | $2,512 | $0 | $0 | $0 | $16,957 | $0 | $288,277 | $0 | $0 | $0 |
| GLEN CUNNINGHAM | ||||||||||||||
| VP POPULATION HEALTH SERVICES | $191,051 | $0 | $36,169 | $0 | $1,197 | $0 | $13,165 | $0 | $38,885 | $0 | $280,467 | $0 | $0 | $0 |
| TROY GARRETT MD | ||||||||||||||
| BOARD MEMBER / PHYSICIAN | $0 | $239,173 | $0 | $906 | $0 | $1,131 | $0 | $18,456 | $0 | $3,932 | $0 | $263,598 | $0 | $0 |
| BECKY PAPE | ||||||||||||||
| QUALITY IMPROVE / REVIEW COORD | $90,323 | $0 | $0 | $400 | $16,315 | $109,403 | $8,982 | $12,093 | $7,150 | $0 | $122,770 | $121,896 | $0 | $0 |
| SHILOH ERVEN | ||||||||||||||
| VP SMG ADMINISTRATION | $171,679 | $0 | $19,510 | $0 | $7,961 | $0 | $14,900 | $0 | $27,489 | $0 | $241,539 | $0 | $0 | $0 |
| NANCY FRY | ||||||||||||||
| VP FINANCE | $196,298 | $0 | $14,772 | $0 | $1,596 | $0 | $15,509 | $0 | $13,288 | $0 | $241,463 | $0 | $0 | $0 |
| ROBERT POWER TERM FEB 2021 | ||||||||||||||
| VP CIO | $57,119 | $0 | $58,255 | $0 | $40,452 | $0 | $10,258 | $0 | $6,539 | $0 | $172,623 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM/FITNESS FACILITY BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. EMPLOYEES CAN USE THEIR WELLNESS BENEFIT AT EITHER NON-SAMARITAN OR SAMARITAN (SAMFIT) GYM/FITNESS FACILITIES. IF AN EMPLOYEE PARTICIPATES AT A NON-SAMARITAN GYM, REIMBURSEMENT IS MADE FOR FEES. REIMBURSEMENT DOES NOT EXCEED $300 PER YEAR AND IS INCLUDED IN THEIR TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. ONE KEY EMPLOYEE USED THE NON-SAMARITAN GYM REIMBURSEMENT DURING THE FILING YEAR. IF EMPLOYEES USE THEIR WELLNESS BENEFIT AT A SAMARITAN (SAMFIT) GYM/FITNESS FACILITY, THEN THE ANNUAL COST OF EMPLOYEE MEMBERSHIP, $300, IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. TWO BOARD MEMBERS, ONE OFFICER, EIGHT KEY EMPLOYEES, THREE HIGHEST PAID EMPLOYEES, AND ONE FORMER KEY EMPLOYEE USED THE SAMARITAN (SAMFIT) GYM/FITNESS FACILITY BENEFIT DURING THE FILING YEAR. |
| PART I, LINE 4B | LINE 4B: THE FILING ORGANIZATION MAINTAINS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. HOWEVER, NO PERSONS LISTED IN PART VII OF FORM 990 ACCRUED DEFERRED COMPENSATION BENEFITS OR RECEIVED ANY PAYMENTS FROM THESE PLANS DURING THE FILING YEAR. |
| PART I, LINE 5 | VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| STATE OF OREGON - FACIL AUTHORITY | ||||||||
| A | 936001787 | 000000000 | 2009-09-30 | $15,800,000 | CONST. OF MEDICAL SCHOOL | 0 | 0 | 0 |
| STATE OF OREGON - FACIL AUTHORITY | ||||||||
| B | 936001787 | 000000000 | 2014-12-18 | $18,952,500 | CONST OF MEDICAL OFFICE BLDG, HOSPITAL REMODELS | 0 | 0 | 0 |
| STATE OF OREGON - FACIL AUTHORITY | ||||||||
| C | 936001787 | 68608JWF4 | 2016-11-16 | $89,533,143 | HOSPITAL FACILITY CONSTRUCTION AND REMODELS | Yes (1) | 0 | 0 |
| STATE OF OREGON - FACIL AUTHORITY | ||||||||
| D | 936001787 | 68608JYJ4 | 2020-07-07 | $77,108,397 | TO REFUND THE 2010 SERIES A BONDS | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Bond DefeasedBondDefeasedAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $7,230,148 | $15,865,543 | $283,537 | $15,582,006 | 2011 | 0 | 0 | Yes (1) | Yes (1) | |||
| B | $4,055,547 | $18,989,505 | $169,620 | $18,819,885 | 2019 | 0 | 0 | 0 | Yes (1) | |||
| C | $91,172,903 | $985,093 | $62,638,694 | 2020 | Yes (1) | 0 | 0 | Yes (1) | $1,030,000 | $27,533,538 | $15,578 | |
| D | $77,108,397 | $1,030,309 | 2020 | Yes (1) | 0 | Yes (1) | Yes (1) | $76,078,088 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) | |||
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) | |||
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) | |||
| D | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) | Yes (1) | 0.00100 | 0.00100 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | Yes (1) | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| D | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: STATE OF OREGON - FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/14/2014 ISSUER NAME: STATE OF OREGON - FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/13/2020 |
| PART II, LINE 3: | DIFFERENCES ON THIS LINE AS COMPARED TO PART I(E) ARE DUE TO INVESTMENT EARNINGS AND UNREALIZED GAINS/LOSSES. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET MIKULA | PersonNm |
| Relationship With Org | KEY EMPL | RelationshipWithOrgTxt |
| Loan Purpose | NEW HIRE RECRUITMENT PACKAGE | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $25,000 | OriginalPrincipalAmt |
| Balance Due | $20,924 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $20,924 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | GLEN CUNNINGHAM AND KIRK GERNER HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF THE SAMARITAN HEALTH SERVICES (SHS) AUDIT AND COMPLIANCE COMMITTEE PRIOR TO ITS FILING WITH THE IRS. SHS'S CHIEF FINANCIAL OFFICER CONDUCTED THE FORM 990 REVIEW WITH THE COMMITTEE AND PROVIDED TIME FOR QUESTIONS FROM THE GROUP. A FORMAL REPORT OF THIS COMMITTEE HAS BEEN MADE TO THE FULL BOARD OF DIRECTORS OF SHS. ADDITIONALLY, A COMPLETE COPY OF THE FILING ORGANIZATION'S FINALIZED FORM 990 AND RELATED SCHEDULES WAS PROVIDED ELECTRONICALLY TO ALL MEMBERS OF THE FILING ORGANIZATION'S GOVERNING BOARD PRIOR TO ITS FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBER CONFLICTS OF INTEREST: THE MEMBERS OF THE BOARD MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CORPORATE COMPLIANCE OFFICER. IF A CONFLICT IS DISCLOSED THAT COULD PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THIS IS EVALUATED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES (SHS) BOARD OF DIRECTORS TO DETERMINE WHETHER THE MEMBER SHOULD CONTINUE TO SERVE ON THE BOARD. IF A CONFLICT IS DISCLOSED THAT DOES NOT PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THE CONFLICT IS MANAGED THROUGH A PROCESS SET FORTH IN THE ORGANIZATION'S BYLAWS. THE BYLAWS PROHIBIT ANY BOARD MEMBER FROM VOTING ON AN ACTION WHERE AN INDIVIDUAL MEMBER HAS A CONFLICT OF INTEREST. EMPLOYEE CONFLICTS OF INTEREST: THE SHS CODE OF CONDUCT AND BUSINESS ETHICS REQUIRES THAT ALL SHS EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST. THROUGH THE HUMAN RESOURCES SOFTWARE, PERFORMANCE MANAGER, THE DISCLOSURE REQUIREMENT NOTICE IS ASSIGNED TO ALL EMPLOYEES AND BY YEAR END ALL TASKS ARE TO BE COMPLETED. IF THERE IS A PERCEIVED CONFLICT OF INTEREST IT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, LEGAL COUNSEL AND/OR SENIOR MANAGEMENT. ACTUAL CONFLICTS OF INTEREST ARE REVIEWED AND DISCUSSED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE OF SAMARITAN HEALTH SERVICES PERIODICALLY ENGAGES AN INDEPENDENT CONSULTANT TO ASSIST IT IN PROVIDING COMPARABLE MARKET DATA FOR THE CEO, WHO IS THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. THIS ANALYSIS INCLUDES REGIONAL AND NATIONAL DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THIS INFORMATION IS USED BY THE COMPENSATION COMMITTEE IN ITS DELIBERATIONS REGARDING THE CEO'S COMPENSATION WHICH IS DOCUMENTED IN THE COMMITTEE'S MINUTES. THE CEO OF THE ORGANIZATION RELIES ON PUBLICLY AVAILABLE INFORMATION TO DETERMINE THE COMPENSATION FOR OTHER TOP MANAGEMENT OFFICIALS WITHIN THE ORGANIZATION. HE CONSULTS WITH THE INDEPENDENT CONSULTANT AS TO THE REASONABLENESS OF THIS DATA TO ENSURE THAT EACH TOP MANAGEMENT OFFICIAL'S COMPENSATION IS REASONABLE AS COMPARED TO SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. PHYSICIAN EMPLOYEE COMPENSATION, INCLUDING PHYSICIANS WHO ARE BOARD MEMBERS, IS REVIEWED AT LEAST ANNUALLY BY SENIOR MANAGEMENT. THIS REVIEW INCLUDES COMPARISON WITH PUBLISHED PHYSICIAN COMPENSATION STUDIES. FOR ALL OTHER EMPLOYEES, THE ORGANIZATION PERFORMS AN ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. SYSTEM-WIDE SUMMARIZED DATA IS ALSO PROVIDED IN THE ANNUAL REPORT TO THE COMMUNITY. THIS REPORT IS MADE AVAILABLE IN KIOSKS AND HIGH-TRAFFIC AREAS OF HOSPITALS AND PHYSICIAN CLINICS, AS WELL AS COMMUNITY PLACES SUCH AS THE PUBLIC LIBRARY. IT IS ALSO DISTRIBUTED TO THE BOARDS OF DIRECTORS AND DIRECTLY MAILED TO DONORS AND NEW RESIDENTS IN THE COMMUNITY. ADDITIONALLY, THE REPORT IS MADE AVAILABLE AT EVENTS, COMMUNITY OUTREACH PROJECTS, AND SCREENINGS ATTENDED THROUGHOUT THE YEAR. GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | BOOK TO TAX DIFFERENCES - JOINT VENTURES 613,556. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| SAMARITAN RESOURCES | |||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 931262271 | ENVIRONMENTAL SERVICES (INACTIVE) | OR | $0 | $0 | SAMARITAN HEALTH SERVICES |
| SAMARITAN MEDICAL SUPPLIES LLC | |||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 465619962 | DURABLE MEDICAL SUPPLIES | OR | $19,780 | $880,658 | SAMARITAN HEALTH SERVICES |
| SAMARITAN DIALYSIS SERVICES LLC | |||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 931246368 | DIALYSIS SERVICES | OR | -$1,256,231 | $19,217 | SAMARITAN HEALTH SERVICES |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALBANY GENERAL HOSPITAL | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930110095 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| ALBANY GENERAL HOSPITAL FOUNDATION | |||||||||||
| 1046 SIXTH AVENUE SW | ALBANY | OR | 97321 | 930712890 | TO SUPPORT ALBANY GENERAL HOSPITAL | OR | 501(C)(3) | 7 | ALBANY GENERAL HOSPITAL | 0 | |
| FIRSTCARE HEALTH FOUNDATION | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930900124 | HEALTH SERVICES FOR LOW-INCOME PATIENTS | OR | 501(C)(3) | 7 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| FIRSTCARE MEDICAL FOUNDATION | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930932697 | FUTURE CHARITABLE HEALTHCARE INITIATIVES (NO CURRENT YEAR ACTIVITY) | OR | 501(C)(3) | 10 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| GOOD SAMARITAN HOSPITAL AUXILIARY | |||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 973393000 | 936024034 | TO SUPPORT GOOD SAMARITAN HOSPITAL | OR | 501(C)(3) | 10 | 0 | N/A | |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||||||||
| PO BOX 1068 | CORVALLIS | OR | 97339 | 237252406 | TO SUPPORT GOOD SAMARITAN HOSPITAL | OR | 501(C)(3) | 7 | GOOD SAMARITAN HOSPITAL | 0 | |
| INTERCOMMUNITY HEALTH PLANS INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 931124326 | CCO PROVIDING MGMT OF INTEGRATED HEALTH SVCS FOR MEDICAID/OHP ENROLLEES | OR | 501(C)(4) | N/A | SAMARITAN HEALTH SERVICES | Yes (1) | |
| LEBANON COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| PO BOX 739 | LEBANON | OR | 97355 | 931260080 | TO SUPPORT LEBANON COMMUNITY HOSPITAL | OR | 501(C)(3) | 7 | MID-VALLEY HEALTHCARE INC | 0 | |
| MID-VALLEY HEALTHCARE INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930396847 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| PARADIGM INDEMNITY CORPORATION | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 731668317 | PURE NON-PROFIT CAPTIVE INSURANCE COMPANY | HI | 501(C)(3) | 12A, I | SAMARITAN HEALTH SERVICES | Yes (1) | |
| GOOD SAMARITAN HOSPITAL CORVALLIS | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 930391573 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| SAMARITAN NORTH LINCOLN HOSPITAL | |||||||||||
| 3043 NE 28TH STREET | LINCOLN CITY | OR | 97367 | 931305493 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| SAMARITAN PACIFIC HEALTH SERVICES | |||||||||||
| 930 SW ABBEY STREET | NEWPORT | OR | 97365 | 931329784 | HOSPITAL SERVICES FOR THE COMMUNITY | OR | 501(C)(3) | 3 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| SAMARITAN SENIOR CARE INC | |||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 931245534 | FUTURE CHARITABLE HEALTHCARE INITIATIVES (NO CURRENT YEAR ACTIVITY) | OR | 501(C)(3) | 10 | SAMARITAN HEALTH SERVICES | Yes (1) | |
| PACIFIC COMMUNITIES HEALTH DISTRICT | |||||||||||
| PO BOX 873 | NEWPORT | OR | 97365 | 930603489 | HEALTHCARE DISTRICT | OR | GOV'T | 0 | N/A | ||
| PACIFIC COMMUNITIES HEALTH DISTRICT FND | |||||||||||
| PO BOX 945 | NEWPORT | OR | 97365 | 930858825 | TO SUPPORT PAC COMM HLTH DIST & SAMARITAN PAC HLTH SVCS | OR | 501(C)(3) | 7 | 0 | N/A | |
| NORTH LINCOLN HEALTH DISTRICT | |||||||||||
| 3043 NE 28TH STREET | LINCOLN CITY | OR | 97367 | 930555769 | HEALTHCARE DISTRICT | OR | GOV'T | 0 | N/A | ||
| NORTH LINCOLN HOSPITAL FOUNDATION | |||||||||||
| PO BOX 767 | LINCOLN CITY | OR | 97367 | 930867677 | TO SUPPORT SAMARITAN NORTH LINCOLN HOSPITAL | OR | 501(C)(3) | 7 | SAMARITAN NORTH LINCOLN HOSPITAL | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SAMARITAN ENDOSCOPY CENTER LLC | ||||||||||||||
| 3600 NW SAMARITAN DR | CORVALLIS | OR | 97330 | 202860067 | MEDICAL SERVICES | OR | N/A | 0 | 0 | |||||
| CORVALLIS MEDICAL BUILDINGS LLC | ||||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 931257913 | REAL ESTATE RENTAL | OR | N/A | 0 | 0 | |||||
| EAST LINN MRI LLC | ||||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 320229399 | IMAGING | OR | N/A | 0 | 0 | |||||
| HULL IMAGING LLC | ||||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 203255479 | IMAGING | OR | N/A | 0 | 0 | |||||
| CORVALLIS MRI LLC | ||||||||||||||
| 3615 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 930949704 | IMAGING | OR | N/A | 0 | 0 | |||||
| MID-VALLEY MEDICAL PROPERTIES ASSOC LLC | ||||||||||||||
| 1046 SIXTH AVE SW | ALBANY | OR | 97321 | 300508747 | REAL ESTATE RENTAL | OR | N/A | 0 | 0 | |||||
| MID-VALLEY MEDICAL BUILDINGS LLC | ||||||||||||||
| PO BOX 557 | LEBANON | OR | 97355 | 931126353 | REAL ESTATE RENTAL | OR | N/A | 0 | 0 | |||||
| NORTHWEST MEDICAL ISOTOPES LLC | ||||||||||||||
| 815 NW 9TH ST STE 256 | CORVALLIS | OR | 97330 | 273007752 | RESEARCH | OR | N/A | 0 | Yes (1) | UNRELATED | -$158,848 | $525,205 | 0.35220 | |
| CASCADE VIEW MEDICAL OFFICE BUILDING LLC | ||||||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 300658805 | REAL ESTATE RENTAL | OR | N/A | 0 | 0 | |||||
| BSM SURGERY CENTER LLC | ||||||||||||||
| 1128 NE 2ND ST STE 201 | CORVALLIS | OR | 97330 | 264349685 | MEDICAL SERVICES | OR | 0 | 0 | RELATED | $34,321 | $17,927 | 0.05000 | DOCBSMASC LLC | |
| AIKENS DIALYSIS LLC | ||||||||||||||
| PO BOX 3004 | TACOMA | WA | 98401 | 464459152 | MEDICAL SERVICES | WA | N/A | 0 | 0 | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SAMARITAN HEALTH PLANS INC | ||||||||||||
| 3600 NW SAMARITAN DRIVE | CORVALLIS | OR | 97330 | 930860860 | HEALTH INSURANCE CARRIER FOR THE COMMUNITY | OR | SAMARITAN HEALTH SERVICES | C | -$329,869 | $33,491,236 | 1.00000 | Yes (1) |
| BOULDER FALLS PROPERTIES LLC | ||||||||||||
| PO BOX 3000 | CORVALLIS | OR | 973393000 | 465293120 | EVENT CENTER & HOSPITALITY SVCS | OR | SAMARITAN HEALTH SERVICES | C | -$421,459 | $14,641,569 | 1.00000 | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (19 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| INTERCOMMUNITY HEALTH PLANS INC | ||
| A | $781,548 | COST |
| INTERCOMMUNITY HEALTH PLANS INC | ||
| L | $4,989,698 | COST |
| INTERCOMMUNITY HEALTH PLANS INC | ||
| O | $265,761 | COST |
| SAMARITAN HEALTH PLANS INC | ||
| A | $249,889 | COST |
| SAMARITAN HEALTH PLANS INC | ||
| L | $1,934,155 | COST |
| SAMARITAN HEALTH PLANS INC | ||
| O | $384,645 | COST |
| GOOD SAMARITAN HOSPITAL CORVALLIS | ||
| L | $62,683,203 | COST |
| MID-VALLEY HEALTHCARE INC | ||
| L | $17,564,662 | COST |
| ALBANY GENERAL HOSPITAL | ||
| L | $29,271,705 | COST |
| SAMARITAN NORTH LINCOLN HOSPITAL | ||
| L | $7,634,176 | COST |
| SAMARITAN PACIFIC HEALTH SERVICES | ||
| L | $15,000,361 | COST |
| ALBANY GENERAL HOSPITAL | ||
| Q | $17,576,513 | COST |
| GOOD SAMARITAN HOSPITAL CORVALLIS | ||
| Q | $33,133,171 | COST |
| MID-VALLEY HEALTHCARE INC | ||
| Q | $13,186,651 | COST |
| SAMARITAN NORTH LINCOLN HOSPITAL | ||
| Q | $5,378,026 | COST |
| SAMARITAN PACIFIC HEALTH SERVICES | ||
| Q | $7,327,163 | COST |
| BOULDER FALLS PROPERTIES LLC | ||
| S | $50,000 | COST |
| BOULDER FALLS PROPERTIES LLC | ||
| A | $90,000 | COST |
| PARADIGM INDEMNITY CORPORATION | ||
| L | $330,000 | COST |