2021-02-16T14:52:40-08:00 2020-03-31 990 2019-04-01 930591528 LEGACY MOUNT HOOD MEDICAL CENTER LEGA 5034155600 24800 SE STARK ST GRESHAM OR 97030 ANNA L LOOMIS CFO & TREASURER 2021-02-16 2019 2022-09-23 18:48:47Z KATHRYN CORREIA 24800 SE STARK ST GRESHAM OR 97030 180833628 false X WWW.LEGACYHEALTH.ORG X 1922 OR Legacy Mount Hood Medical Center (LMHMC) was founded in 1922 and is a community hospital in Gresham, OR. LMHMC offers a wide range of services including family birth, diagnostic services, cancer treatment, surgery and emergency services. 16 12 0 274 512085 -59271 125863 105176 172512728 180589038 -35786 117949 0 172602805 180812163 1200 1000 0 75868365 79945263 0 0 79443620 88789809 155313185 168736072 17289620 12076091 129435978 137025046 44635164 40178389 84800814 96846657 Legacy Mount Hood Medical Center (LMHMC) was founded in 1922 and is a community hospital in Gresham, Oregon with 115 licensed beds. LMHMC offers a wide range of services including family birth, diagnostic services, cancer treatment, surgery and emergency services. LMHMC is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and achieve them Responsibility - Be good stewards of our resources, ensuring access to care for all Innovation - Be progressive in our thinking and actions Leadership - Serve as a role model of good health and good citizenship false false 129149218 1000 180589037 LMHMC provides inpatient and outpatient healthcare services to the communities it serves. In support of its mission, LMHMC voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. During fiscal year 2020, LMHMC provided financial assistance on approximately 12,200 patient accounts (of which 2,099 accounts received discounts totaling 100% of costs) and resulted in LMHMC incurring roughly $6,747,500 in uncompensated costs associated with this program. In addition to charity care, LMHMC provides services under various states' Medicaid programs for financially needy patients, Medicare beneficiaries and other government programs for which the cost of treating these patients exceeds the government payments received. During fiscal year 2020, LMHMC incurred approximately $6,658,230 $7,483,660 and $350,990 in uncompensated costs attributable to Medicaid, Medicare, and other government programs, respectively. LMHMC also provides a variety of other community benefit activities such as medical education, donations to other charitable entities, research, and other health improvement services which totaled roughly $1,496,228 during fiscal year 2020.LMHMC is part of Legacy, which collectively provided over $51 million, $207 million, $193 million, and $5 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2020. In addition, Legacy provided over $27 million in other community benefit activities during fiscal year 2020. 129149218 true true false true false false false false false true true true false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 0 0 false 0 true true false false false false false false 0 false false false false false false false X 16 12 false true false false true true true true true false false true true true true true true true true true true OR X X ANNA LOOMIS 5034155600 1919 NW LOVEJOY STREET PORTLAND OR 97209 KATHRYN CORREIA President & CEO 0.00 40.00 X X 0 1465049 79902 LEWIS L LOW MD SR VP 0.00 40.00 0 777140 66181 ANNA LOOMIS CFO & TREASURER 0.00 40.00 X X 0 775887 46637 TRENT S GREEN SR VP 0.00 40.00 0 733558 87156 ROBERT E DEWITT SR VP & SEC 0.00 40.00 X X 0 759250 38761 BRYCE R HELGERSON SRVP CIO 0.00 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NONCURRENT WORKERS' COMP LIABILITY 135412 29952306 180334521 180334521 477642 477642 180812163 167962100 167962100 773972 773972 168736072 Part V, Line 4: Intended uses of the endowment fund. Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Mount Hood Medical Center Foundation (MHMCF) maintains all charitable gifts including endowment funds for the benefit of LMHMC and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator. Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S FOUNDATION CONTRIBUTION $90301 ROUNDING $-542 $0 MEDICAL STAFF INCOME $99375 GAIN / LOSS OF SALE OF ASSETS $178535 FOUNDATION CAPITAL CONTRIBUTION $14875 PROGRAM SERVICE REVENUE $95098 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S FOUNDATION CONTRIBUTION $90301 ROUNDING $-293 $0 MEDICAL STAFF EXPENSE $410331 GAIN / LOSS OF SALE OF ASSETS $178535 PROGRAM SERVICE REVENUE $95098 true true X true X 300.000000000 true X true true true false true true 6747523 6747523 0.04000 40274528 33616291 6658237 0.03950 2429183 2078192 350991 0.00210 49451234 35694483 13756751 0.08160 388235 388235 0.00230 894702 894702 0.00530 213290 213290 0.00130 1496227 1496227 0.00890 50947461 35694483 15252978 0.09050 false 5732104 4700325 25310691 29682638 -4371947 X true true 1 1 LEGACY MT HOOD MEDICAL CENTER 24800 SE STARK STREET GRESHAM OR 97030 www.legacyhealth.org 14-1337 X X X LEGACY MT HOOD MEDICAL CENTER 1 false false true X X X X X X X X X 17 true true true true X www.legacyhealth.org true 17 true www.legacyhealth.org false false true X 300.0000 400.0000 X X X X X true true X X X true X www.legacyhealth.org X www.legacyhealth.org X www.legacyhealth.org X X X X X X true X false X X X X true X false false Facility: LEGACY MT HOOD MEDICAL CENTER - Part V, Section B, Line 5 In 2017, Legacy Mount Hood Medical Center participated with the 14 other hospitals, four public health departments and two Coordinated Care Organizations in the metro four county area regional Healthy Columbia Willamette Collaborative Community Health Needs Assessment (CHNA) which was used as a base for the Legacy Mount Hood Community Health Needs Assessment. The results of Legacy's community needs assessment can be found at www.legacyhealth.org.The 2017 Community Needs Assessment is conducted based on the Healthy Columbia Willamette Collaborative (HCWC) Community Health Needs Assessment (CHNA). The HCWC CHNA is regional and developed to improve efficiency and effectiveness and also to help meet the requirements of the ACA and Public Health Accreditation. The regional CHNA obtained information from the community through a variety of venues -online surveys and interviews with public health, tribal, regional, state or local health or other departments as well as medically underserved, low income and minority populations and those with chronic disease needs; a review of community engagement/needs assessment projects; and community listening sessions with uninsured and/or low-income community members from diverse culturally-identified and geographic communities. In the latest round of work, the Collaborative also reviewed population data (health-related behaviors, morbidity, mortality); medical data from local CCOs (most frequent conditions Medicaid-covered individuals sought care for); and hospital data (uninsured patients seen in the emergency department for conditions that could have been managed in primary or ambulatory care settings). The following organizations were surveyed or interviewed.Adelante Mujeres Adult Mental Health and Substance Abuse Advisory Council Allies for a Healthier Oregon Ant Farm Calvary Church Central City Concern Clackamas County Public Health Advisory Committee Clackamas Service Center Coalition of Community Health Clinics Elders in Action Commission El Programa Hispano FamilyCare Community Advisory Council Free Clinic of SW Washington Hacienda CDC Health Share of Oregon Community Advisory Council Highland Church & Highland Access, Reentry and Recovery Program Immigrant and Refugee Community Organization The Intertwine Alliance Latino Network Liberation Street Church Lifeline Connections LifeWorks Northwest Multnomah County Health Equity Initiative Native American Youth Association National Alliance on Mental Illness (Clackamas) OHSU Richmond Clinic Health Literacy Committee Oregon Community Health Worker Association Oregon Health Equity Alliance Outside In Oregon Foundation for Reproductive Health Oregon Public Health Institute Project Access NOW Q Center Urban League of Portland Veterans Affairs Hospital Washington County Mental Health and Addictions Advisory Council Washington County Public Health Advisory Council Facility: LEGACY MT HOOD MEDICAL CENTER - Part V, Section B, Line 6a In addition to Legacy Mount Hood Medical Center, the HCWC comprised of 14 other hospitals in the metro area and are as follows : Adventist Medical Center, Kaiser Permanente Sunnyside Medical Center, Kaiser Permanente Westside Medical Center, Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center, Legacy Salmon Creek Medical Center, Oregon Health & Science University, Peace Health Southwest Medical Center, Providence Milwaukie Medical Center, Providence Portland Medical Center, Providence St. Vincent Medical Center, Providence Willamette Falls Medical Center and Tuality Health Care/Tuality Community Hospital. Facility: LEGACY MT HOOD MEDICAL CENTER - Part V, Section B, Line 11 The HCWC, through their online survey, listening sessions, and an inventory of community engagement projects, identified the following top five issues faced by the community: Homelessness and the lack of safe, affordable housing Unemployment and lack of living-wage jobs Mental and behavioral health challenges Hunger and lack of healthy, affordable food Lack of access to physical, mental and/or oral health careCompilation of the 2016 HCWC data provided the following emerging health issues faced by the community served: Access to health care No usual source of health care among adults Asthma in low-income and uninsured children Depression in adults Diabetes and hypertension in adults Cancer (breast, colorectal and lung) Lack of dental visits for adultsBased on the 2016 HCWC CHNA findings, Legacy Mount Hood is focusing its efforts on the following priority issues:Access to Care Improving residents ability to get the health care services they need, with an emphasis on primary and preventive care and management of chronic conditions such as asthma in children and diabetes and hypertension in adults.Behavioral Health-Expanding the availability of and access to behavioral and mental health services for youth and adults to help address such conditions as depression, suicide, and PTSD.Social Determinants of Health-Addressing the need for policies, systems, services, and environments that support healthy behaviors, which means advancing solutions for such issues as homelessness and affordable housing for the underserved, food scarcity and, once again, access to health care. Education, meaningful employment, and removing barriers to culturally competent services are key to improving the health of the community.Details on the specific initiatives Legacy Mount Hood is undertaking to address these priority issues can be found in the Community Health Improvement Plan (CHIP), which can be found on the organizations website at www.legacyhealth.org. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense LMHMC uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, LMHMC must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The estimated amount of bad debt expenses attributable to charity care policy was calculated using the demographic profile of household income and average household size in the zip code areas around the hospital. 82% of Households in the LMHMC service area would qualify for financial assistance with incomes under 400% of the Federal Poverty Guidelines under this methodology. Part III, Line 4 - Bad Debt Expense The footnote that describes the Legacy bad debt expense can be found on Page 11 of the attached audited financial statements. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $58,627,100 and $66,110,800 respectively. This results in a total Medicare shortfall of $7,483,700.Costing Methodology (Part III, Line 8).Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Legacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues. Part VI, Line 2 - Needs Assessment The described CHNA provides the primary source for assessing needs. Senior leadership, in conjunction with the Board of Directors, continually assesses the needs of the communities it serves through a compilation of primary and secondary market research (qualitative and quantitative), medical staff input, reviewing national trends and practices, working with local foundations and funders regarding their assessments, and working with local community-based partners to understand their needs. The goal is to understand the needs and develop programs specific to the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of these assessments is the development of both long-term and fiscal year plans that are supported by a yearly budget that is proposed by staff and approved by the Board of Directors. Community Benefit and Community Relations staff as well as Legacy representatives on nonprofit and community based boards serving communities at risk also provide ongoing informal feedback regarding needs. These are then aligned to the community health needs identified in the formal CHNA. The region served by Legacy Mount Hood Medical Center (LMHMC), along with most of Oregon, is experiencing significant challenges in population growth, economic development, education and health care. Recognizing that social and economic determinants impact health, LMHMC has been and will remain committed to addressing these issues to improve the health of all residents in the community, including equity among ethnically diverse populations.In Legacy Mount Hoods previous CHNA, we identified access to health care, chronic disease, mental health, substance use disorder, health literacy and education and youth as our CHNA priorities. Since this last report, we have invested time, resources and funding in programs and services we believed would have an impact on these needs. A $10 million Community Health Fund was established in 1998 by the Legacy Health Board. The funding is supported by operating revenue on an annual basis. Every partner organization receiving funding meets the needs identified in the CHNA. Part VI, Line 3 - Patient Education of Eligibility for Assistance Legacy Mount Hood employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans assistance, Legacys financial assistance program, and public assistance programs, such as Medicaid.The criteria for financial assistance under LMHMC's program is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for medically necessary services provided. Specifically, the LMHMC Financial Assistance Program provides an uninsured discount of 35% to patients who are self-pay. Further discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level or roughly $104,800 for a family of four in Portland, Oregon. For patients whose household income is at or below 300% of the federal poverty level, a full subsidy is available. In addition to the householdincome criteria, the patients' qualified assets (e.g. 25% of household assets), and other catastrophic or economic circumstances are considered in determining eligibility.In addition to financial counselors and social workers, LMHMC makes every effort to communicate its Financial Assistance Program to all patients. This includes signage in main admitting areas of the hospital and brochures explaining financial assistance in all patient care areas, translated for patients/individuals with limited English proficiency (LEP). Financial counselors are available to assist patients in understanding and applying for available resources, including the LMHMC Financial Assistance Program. LMHMC's website also has information about the availability of financial assistance. LMHMC offers financial assistance customer service Monday through Friday, as well as the availability of voice mail so patients can leave confidential, detailed messages during non-business hours. Patients are encouraged to sign up for MyHealth, a secure online tool to access their medical record. Using their MyHealth account they can correspond with a financial counselor via email. Finally, all of Legacys billing statements include information regarding the availability of financial assistance. If LMHMC requires the use of a collection agency, those agencies are required to provide a telephone number that patients can call to request financial assistance.In 2010, Legacy Health established the Health Literacy initiative. Nearly all Legacy employees are touch points to patients and families and health literacy is involved in every touch point.What is health literacy? The Institute of Medicine defines health literacy as the capacity to obtain, understand, and process basic health information and services needed to make appropriate health decisions. In short, health literacy is the ability to understand and act on health information. Nearly half of the U.S. adult population has a low level of health literacy. Patients with low health literacy are less likely to comply with treatment, less likely to seek preventive care and twice as likely to be hospitalized. Quality, safety and cost are all affected by a patient's inability to understand medical instructions and to explain their symptoms/issues. Legacy's employees are learning and practicing new way of communicating with patients using health literacy tools such as universal precautions, plain language and teach back methods.Annual education is provided to all billing and admitting staff so they can be kept informed of and speak with knowledge about current financial assistance policies and options. Legacy Mount Hood provides copies of the latest policies in main admitting areas, as well as with the hospital financial counselor, online via the website and through MyHealth. Since 2008, the four-county metro area health delivery systems (encompassing all hospitals in the area) and safety net clinics have partnered to establish a seamless, coordinated program (Project Access NOW) to provide care for the low income uninsured. This program enables low income uninsured patients to receive continuity of care in earlier stages of acuity due to the collaboration among nearly 3,000 providers and all health systems. Part VI, Line 4 - Community Information LMHMC is located in Gresham, a suburban area about 25 miles east of downtown Portland. The total service area extends from the Columbia River in the north to Estacada in the south and from 122nd Avenue in the west to Mt. Hood in the east. The five mile primary service area includes the cities/towns of Gresham, Troutdale,Fairview, Corbett and Wood Village. Zip codes for the primary service area include: 97009,97024, 97030, 97055, 97060, 97233, 97236, and 97080.While Gresham is the fourth largest city in Oregon, the other communities are much smaller in population. The communities are contiguous to each other. People living in this area perceive themselves as distinct from Portland, Oregon, although the majority works in Portland. The towns have strong local governments and identities.The primary service area is situated in the eastern third of the same county as the larger urban core--Portland (referred to as East Multnomah County). This presents challenges as the urban center/county seat consumes the majority of dollars and services and East Multnomah County often feels ignored. The situation is especially pressing as demographics are shifting such that East Multnomah County requires additional services and dollars, but struggles to be heard relative to Portland. The area is working diligently to have a stronger employment base which is critical for schools, public sector services and autonomy within the county.The population of the five mile primary service area was 115,365 during this reporting period. East Multnomah County is expected to grow at a higher rate than West Multnomah County. Multnomah Countys certified population estimate as of July 1, 2019 was 812,855. By ethnicity and race, the Legacy Mount Hood primary service area is 69.1 percent non-Hispanic white, 12 percent Hispanic, 8.1 percent Asian and Pacific Islander, 6 percent African American/Black, 4.7 percent other, and 1.4 percent Native American.As home and rental costs in the City of Portland have increased significantly in the past decade, communities of color have sought housing in the surrounding communities, often moving east. The African American/Black population continues to be most concentrated in the historical neighborhoods of North/Northeast Portland, but increased housing prices have resulted in the community moving increasingly to East Multnomah County.Hispanics are moving into the LMHMC service area at a higher rate than any other group (more than doubling in numbers in the past 15 years). Additionally, they have a higher birth rate than other communities of color. The Hispanic population accounts for about one-fifth of the births in Oregon, while they make up just one-tenth of the population. A number of the elementary schools in East County are 50 percent Hispanic.The Slavic community, in addition to the Hispanic community, has settled in the area. While still a small population relative to the entire metro area, specific geographic areas are experiencing significant growth in the Slavic population, particularly in the southern East Multnomah County. Slavs are counted in the non-Hispanic white population, but they have distinct cultural identity. Their socioeconomic indicators are generally lower than the other non-Hispanic white population.The immigrant and refugee population is growing significantly in the region. Recent immigrants and refugees are more likely to be culturally and linguistically isolated. Speaking a language other than English at home has increased significantly, particularly in East County and specific neighborhoods such as Rockwood which is located on the edge of west Gresham. Spanish is the most common language spoken followed by Slavic languages.Multnomah Countys median household income (MHI) from 2014-2018 was $64,337 with 12.0 percent of the population living below the federal poverty level, a decrease of 2.4 percent from the previous year. In Multnomah County,non-Hispanic white median household income was at $55,346, while Black/African Americans had the lowest MHI of $27,347 followed by American Indian/Alaska Native at $29,695 and Hispanic/Latino at $36,572. In contrast, Asians MHI was $54,561. Families living below poverty level show non-Hispanic white at 7.9 percent relative to Asian at 12.6 percent, two or more races at 19.6 percent, Black/African American at 32.6 percent, Hispanic/Latino at 30.7 percent and American Indian/Alaska Native at 35.5 percent. The Dignity Health and Truven Health Community Needs Index (CNI) is accepted as the national standard in identifying communities with health disparities and comparing relative need. CNI for the Legacy Mount Hood primary service area shows highest need in close proximity to Mount Hood: 97024-Fairview, 97030-Central Gresham, 97230-Argay, and 97236-Powell Butte. Notably, one of the highest need communities in Oregon is 97233-Rockwood/Centennial, located adjacent to Legacy Mount Hood. One-fourth of the census tracts Rockwood as a Medically Underserved Population (MUA) designation with an uninsured population of 30 percent. The LMHMC is the sole hospital in the primary service area. Three other health systems have a strong clinic presence.With the long-standing income disparities and increase in diversity in the LMHMC area, safety net services have expanded and emerged. Multnomah County Health Department operates FQHCs in inner Gresham and Rockwood, a neighborhood on the western edge of Gresham (the site of one of the highest Community Needs Index scores in the entire metro area). The Wallace Medical Concern, formerly a volunteer staff safety net clinic, obtained FQHC status and is now housed in Rockwood. A physician staffed safety net clinic is also in Gresham. Legacy Medical Group Clinic in Sandy is 13 miles from the hospital and is a designated Rural Health Center.A local non-profit, Project Access NOW, links uninsured low income individuals to no-cost healthcare services. All of the health systems in the metro area are very involved with this program. Legacy Health provides cash donations as well as clinical services.While the Affordable Care Act has significantly lowered the uninsured rate in Oregon, longstanding income disparities in the Legacy Mount Hood service area underscore the ongoing need for safety net services, which are detailed in the separate CHIP document which can be found on the organizations website.In FY 20, LMHMC provided $6.7 million in charity care and $13.7 million in total unpaid costs of care for those in need. LMHMC has historically been among the highest charity care provider as percent of charges among all metro area hospitals. Part VI, Line 5 - Promotion of Community Health Non-cash donations of resources include clinical and non-clinical services and items, e.g., screenings and support services, internships, information and referral services and health fairs. Legacy's warehouse located in NW Portland is open to nonprofit organizations to obtain surplus equipment and furniture. In addition, conference room space is made available to local nonprofits for Board and community meetings.Clinical staff is involved with local communities through many child safety programs. In 1986, nurses in Legacy Mount Hoods sister hospital, Legacy Emanuel, developed the Trauma Nurses Talk Tough (TNTT) program. The American Hospital Association awarded the TNTT program its NOVA Award. In addition, Legacy staff members conducted 541 free checks to show parents how to properly install car seats. Last year, Legacy staff fit and distributed 5,152 low cost helmets and safety gear to children, of which 1,381 were donated. Legacy staff also provide new parents with training to reduce the incidences of shaken baby syndrome as well as an education and awareness program about window safety (to prevent children falling from upper stories).The COVID-19 pandemic swept across the U.S. in the last few months of FY20. The COVID-19 pandemic presented unforeseen challenges within our communities and heightened the need for community benefit. The health and economic impacts of this crisis continue to grow and evolve. The economic implications of COVID-19 have constrained the availability of resources and required Legacy to redirect funding and develop new strategies in response to emerging community needs. As we enter unprecedented times, we will continue to leverage community collaborations to identify new ways to engage community and maximize resources and impact. Part VI, Line 6 - Affilated Health Care System LMHMC is a subsidiary of Legacy Health (Legacy). Legacy is an integrated health system based in Portland, Oregon and primarily operates six acute care hospitals and related services (e.g., physician practices, hospice, preferred provider network) in the four-county metro area of Portland and SW Washington, and Marion County. In addition, Legacy Health is a collaborative partner with Unity Center for Behavioral Health.The Legacy Board is comprised of community and business leaders as well as representatives of the medical staff. The LMHMC medical staff is open, with physicians submitting credentialing information reviewed according to LMHMC policies and standards. In 1998, the Legacy Health Board approved a $10 million Community Health Fund from operating revenue to address major community health issues. The Fund aims to provide annual grants to community-based programs addressing racial and ethnic disparities and inequities. The Community Health Fund has provided 52 grants since 1998 totaling over $9.7 million.In addition to our Community Health Fund contributions, $435,000 in grant funding was awarded to community-based organizations in Clackamas, Clark, Marion and Washington counties, to strengthen organizational capacity and support programs and initiatives that address the social determinants of health and health equity, focused on early childhood education and meaningful employment.Recognizing that education, employment and income inequities exist for communities of color, and that health professions are lacking in diversity, Legacy established the Health Occupation Profession and Education-HOPE program (formerly Youth Employment in Summer-YES). Each year between 5 and 15 students of ethnically diverse communities receive paid summer employment in departments where they work with health professionals; students are paid between $13-17 per hour and may work up to 400 hours during the summer. HOPE students also receive college scholarships between $3,000 and $10,000 annually. Students remain in the program as long as they remain in school and pursue health careers. Some students remain in the program as long as seven years graduating with a range of degrees from imaging tech, to bachelors in nursing, to medical residents. The vast majority of the students are the first in their families to go to college. While the HOPE students were unable to work due to supplemental employment pauses due to COVID-19, we were able to provide students with their education scholarships.In addition to the Community Health Fund, Legacy provided cash donations to local health and human service, education, economic development and civic organizations. Donations focus on organizations with year-round relationships through programs and board representationspecifically focused organizations addressing disparities. An example in the Legacy Mount Hood service area includes a strong partnership with The Wallace Medical Concern, a local safety net clinic serving a significant majority of Latinos.In 2010, Legacy Health established the Health Literacy initiative which focused on ensuring patients both understand and are able to act on the information required of and provided to them, which is critical to their health outcomes. For almost a decade, Legacy Health led the way in bringing high-quality health literacy experts to Portland to support organizations in better serving our communities through health literate communication tools and best practices shared at our annual Legacy Health Oregon & SW Washington Health Literacy Conference. Due to COVID-19, we had to cancel the 2020 conference and have since decided to retire the Oregon & SW Washington Health Literacy Conference to refocus efforts to continue to align with the needs of our communities. Legacy continues to be committed to health literacy and community engagement focused on equity and inclusion.In the fall of 2018, Legacy Health in collaboration with Kaiser Permanente NW, PeaceHealth and Providence Health & Services came together to create the Health Systems Access to Care Fund through the Oregon Community Foundation. The goal of this funding opportunity is to strengthen the capacity and infrastructure for community clinics that are expanding and/or adapting their current models to respond to the changing needs of patient populations due to ongoing healthcare reform, Medicaid transformation, and the increasing pressure on the safety net for access to care. Ten clinics were invited to apply, and eight clinics were awarded at the beginning of January 2018. Grantees had access to $100,000 over two years. Clinics received training and individual technical assistance in various areas of organizational development for community supported clinics.In addition to the Community Health Fund, Legacy provided cash donations to local health and human service, education, economic development and civic organizations. Donations focus on organizations with year-round relationships through programs and board representationspecifically focused on organizations addressing disparities. Examples include Virginia Garcia Memorial Health Center, Latino Network, Ronald McDonald Charities, Free Clinic of SW Washington, Silverton Area Community Aid, Trillium Family Services, National Alliance on Mental Illness Oregon, Native American Youth and Family Center, and Basic Rights Oregon. Part VI, Line 7 - States Filing of Community Benefit Report OR true true false true true true true false true true ANNA LOOMIS CFO & TREASURER 649223 121001 5663 17255 29382 822524 ANNE T GREER Secretary 254953 54740 22239 34803 21663 388398 ARUNA JAYARAM MD PHYSICIAN 194059 67123 -467 44833 11235 316783 BRYCE R HELGERSON SRVP CIO 484800 115739 28666 104432 16090 749727 25108 CAROL A BRADLEY SR VP 309870 78521 186106 57388 26121 658006 14986 GRETCHEN M NICHOLS HOSPITAL PRESIDENT 372970 99609 -1371 45296 27351 543855 JASPREET KHANGURA MD MEDICAL DIRECTOR 248629 55598 -4839 16288 18534 334210 JOHN J KENAGY SR VP 429910 99314 20084 47218 37618 634144 JONATHAN HILL MD BOARD DIRECTOR 335196 12500 4407 7000 38748 397851 KATHRYN CORREIA President & CEO 1232535 229310 3204 41925 37977 1544951 LAURA E OSTROM MD PHYSICIAN 252415 9371 -2580 23639 19423 302268 LESLIE ROOT MD BOARD DIRECTOR 152418 72059 -313 20657 3491 248312 LEWIS L LOW MD SR VP 598708 101927 76505 40086 26095 843321 MAUREEN A BRADLEY SR VP 289952 57078 4150 68484 19022 438686 MICHELLE L JOHN PHYSICIAN 172540 65628 -5022 22706 17031 272883 ROBERT E DEWITT SR VP & SEC 421907 85048 252295 22688 16073 798011 102545 SHEVYLL S TAN MD MEDICAL DIRECTOR 215268 -3891 7292 29036 247705 SONJA O STEVES SR VP 397090 71308 -1468 112405 27913 607248 TANYA R SHANKS-CONNORS INTERIM HOSPITAL PRESIDENT 212971 48322 -1332 33404 24027 317392 TRENT S GREEN SR VP 625384 109986 -1812 51633 35523 820714 Part I, Line 5b: Explanation of organization compensation based on revenues of related organization Physicians employed by Legacy affiliates are paid variable compensation based on quality, value, and production. Production is based upon the level of effort of services provided during the year measured by industry standard relative value units (RVU) and which generate revenue. Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or Legacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets. Part I, Line 8: Amounts reported on 990 VII pursuant to initial contract exemption described in Regs Legacy enters into initial employment agreements with Executives that qualify under the initial contract exception. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee relies on comparable market data and all decisions are documented. Part III, Additional Information Sch J, Part 1, Question 3 Regarding Compensation PracticesDirectors for Legacy started receiving compensation for their services in August 2014. They also receive expense reimbursements related to their duties. Any expense reimbursements to board members are reviewed by the Director of Tax for determining 1099 tax reporting. In addition to the Board of Directors compensation, during 2019, Dr. Hill received compensation related to his duties as Medical Director while Dr. Root received compensation for medical services provided at Legacy Emanuel Hospital. Dr. Fullman received compensation for medical services provided to Legacy Meridian Park Hospital. There was no other reportable compensation received by any board member during 2019.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market.The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for executive positions. The Committee oversees the system's governance procedures with respect to intermediate sanctions legislation and the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Sch J, Part II, Column Breakdown Of W-2 Or Misc-1099:Column B(i) - Base compensation consists of regular base pay including employee elected deferrals for retirement plans (403(b) and 457(b) plans).Column B(ii) - The incentive compensation program for Legacy is based on predetermined criteria and reviewed and approved by the Board. Bonuses are paid to key employees for interim duties outside their primary responsibilities (e.g. Acting in Capacity).Column B(iii) - Other compensation consists of deferred compensation amounts paid toexecutives during the current year and were reported on prior form 990 returns. These amounts include arrangements that contain elements of a substantial risk of forfeiture conditioned on continued employment, vesting and/or a noncompete provision upon termination of employment. Distributions from 457(b) plans, reported to the employee on a 1099-R, are also included as other compensation. In addition, imputed income for insurance, cell phone and other benefits is included in other compensation as well as any severance related payments.Column C - Deferred compensation includes the contributions to defined contribution plans, amounts deferred under the 457(f) plan including earnings, earnings in the 457(b) plan, and the value of the pension restoration plan. Earnings on the 457(f) and 457(b) include gains and losses on the underlying investments.The defined contribution plan is available to all employees as they become qualified to participate. The pension restoration plan provides executive pension benefits in excess of IRS mandated limits on eligible compensation to key executives. The benefits are unfunded and subject to forfeiture. Executive pension benefits are intended to make the executive's retirement benefit, as a proportion of their final average salary, comparable to all other employees, and are treated as income when paid.The Legacy Health Board approved the goals and long-term objectives for the Executive Long-Term Incentive Plan effective April 1, 2017 for 3 years ending on March 31, 2020. The plan was discretionary and could be terminated at any time. The purpose of the Plan was to achieve market share growth in key areas identified in Legacy Healths strategic plan. Targets for operating margins and clinical quality were required over the three-year period and all goals were measured at March 31, 2020. The plan was funded and paid out in August 2020 after approval from the Legacy Health Compensation Committee and the Legacy Health Board. A portion of the pay out was reported as deferred compensation on the FY2018 and FY2019 990. The balance will be reported as deferred compensation for FY2020.Column D - Nontaxable benefits include company paid health and welfare and long term care and disability benefits under group plans.Column F - Current year compensation reported as deferred in prior years. Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company Legacy Health (Legacy) provides management services for all of its affiliated companies which includes, accounting, purchasing, contracting, legal, human resources, information technology, billing, facilities, budgeting, transcription, security, public relations, strategic planning, organization development. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Legacy Health is the sole member of Legacy Mount Hood Medical Center. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors includes the following members: (a) The Bishop of the Oregon Synod of the Evangelical Lutheran Church inAmerica (the XOregon Synod") or the Bishop's designee, who shall serve ex officio;(b) The Bishop of the Episcopal Diocese of Oregon (the "Episcopal Diocese")or the Bishop's designee, who shall serve ex officio;(c) One (1) person elected by the Legacy Health Board of Directors pursuant to the process set forth in the Bylaws; provided, however, that such person shall be an active member of a Lutheran congregation in the Oregon Synod ("Lutheran Director");(d) One (1) person elected by the Legacy Health Board of Directors pursuant to the process set forth in the Bylaws; provided, however, that such person shall be an active member of an Episcopal congregation in the Episcopal Diocese known to his/her parish priest, or alternatively a member of the clergy in the Episcopal Diocese ("Episcopal Director"). Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The election of Lutheran Director is subject to the approval by the Bishop of the Oregon Synod, who may object to the newly-elected director for any reason by delivering written notice to the Legacy President or the Chair of the Board of Directors no later than one week after the election. If the Bishop timely objects to the election of the new Lutheran Director, the election will be ineffective and that person will not be a director; otherwise, if no timely objection is received, that person shall be conclusively presumed to be the Lutheran Director for his/her full term or the remainder of an unexpired term to which elected. The election of the Episcopal Director is subject to approval by the Bishop of theEpiscopal Diocese, who may object to the newly elected director for any reason by delivering written notice to the Legacy President or Chair of the Board of Directors no later than one week after the election. The election of the Episcopal Director is also subject to approval by the Standing Committee of the Episcopal Diocese, who may object to the newly elected director only on the grounds that he/she is not an active member of an Episcopal congregation or a member of the Episcopal clergy in the Episcopal Diocese; such objection to be effected by delivering written notice to the Legacy President or Chair of the Board of Directors within five days after the next meeting of the Standing Committee or 45 days after the election, whichever isearlier. If the Bishop or Standing Committee timely object to the election of the new Episcopal Director, the election will be ineffective and that person will not be a director; otherwise, if no timely objection is received, that person shall be conclusively presumed to be the Episcopal Director for his/her full term or the remainder of an unexpired term to which elected. Form 990, Part VI, Line 11b: Form 990 Review Process The Legacy Board received a copy of the 990 return prior to filing. At the direction of the entire Board, the Board Compensation Committee reviewed the compensation disclosures and the Board Audit and Compliance Committee reviewed the 990 returns for Legacy and Legacy Emanuel Hospital & Health Center with Management prior to filing. Any key differences in disclosure for other affiliated entities, including Legacy Mount Hood Medical Center were discussed with the Board Audit and Compliance Committee. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The following is a summary of Legacy's policy and procedures for conflict of interest disclosure, monitoring and resolution.All Legacy employees and non-employees in leadership positions (e.g., Board members, Foundation Trustees, Medical Directors) are required to disclose potential conflicts of interest as the conflict arises. All employees are required to disclose any conflict of interest per the Standard of Conduct policy. Certain groups have annual formal disclosure requirements, Executives and non-employees in leadership positions complete the Conflict Disclosure Statement from the Standards of Conduct policy annually. Officers, Directors, Trustees, Key and Highly Compensated employees are also required to complete a questionnaire covering business relationships, business transactions with interested parties, loans and grants. Conflict Disclosure Statements and questionnaires are returned to Legacy Corporate Compliance or Tax Departments for review of the disclosure. If a conflict is disclosed, or identified through any other means, Legacy Corporate Compliance ensures that management mitigates the risk (e.g., discontinues relationship with vendor, segregates responsibilities, recuses Board member from voting in area of conflict) and that the conflict and mitigation steps are reported to the appropriate level (e.g. Audit and Compliance Committee of the Board). Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The following describes the compensation practices of Legacy and its affiliates.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee oversees the system's governance procedures with respect to the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Legacy Health's audited and interim consolidated financial statements are publicly available on the Electronic Municipal Market Access(EMMA) (www.emma.msrb.org) and DAC Bond (www.dacbond.com) websites. Legacy's audited consolidated financial statements include consolidating schedules which highlights LMHMC's financial results.When changes are made to the LMHMC Articles or Bylaws, LMHMC discloses and attaches copies to the IRS Form 990, which are publicly available by request or on various public websites such as Guidestar(www.guidestar.org). Other governing documents are not available to the public. Other Changes In Net Assets Or Fund Balances - Other Decreases GIFT SHOP OPERATIONS FUND = -$30247 Other Changes In Net Assets Or Fund Balances - Other Decreases ROUNDING = -$1 Form 990, Part IV, question 12 Legacy has an audit of its consolidated financial statement which includes consolidating schedules highlighting LMHMC's financial results. Form 990, Part VI, question 2 Legacy Health System CPC, LLC (CPC) is a common pay agent for Legacy and its affiliates. The CPC files all required federal employment tax returns for Legacy and its affiliates. The number of employees reported on Form W-3 for LMHMC is 1,000. Form 990, Part X LMHMC participates in the Legacy investment pooled funds which include professionally managed equity and fixed income securities in both separately managed portfolios and commingled investment accounts. Investment returns are prorated according to each affiliate's share of the pool. Form 990, Schedule J Schedule J Reporting of Officers and Senior Management on Legacy Affilate Returns. The Legacy Officers, Senior Vice Presidents and other key employees may have responsibilities for the operations of the entire health system, including the affiliated entities. Their compensation is paid from and reported on the Legacy return(EIN 23-7426300). The compensation is reported again for informational purposes on related affiliated entity returns including, Legacy Emanuel Hospital & Health Center, Legacy Good Samaritan Hospital and Medical Center, Legacy Meridian Park Hospital, Legacy Mount Hood Medical Center, Legacy Salmon Creek Hospital, and Legacy Visiting Nurse Association. 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