NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK (EIN 93-0622075)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-13
- IRS object ID
- 201923179349303127
- Schema version
- 2018v3.1
- 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 H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-13T10:39:24-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3121 W March Ln Ste 200 | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952192367 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930622075 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Medical Foundation Tillamook | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 9164060000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Third Street | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Micah Smith | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 9164060000 | PhoneNum |
| Signature | 2019-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tracy S Paglia | PreparerPersonNm |
| PTIN | P00366884 | PTIN |
| Phone | 2099556100 | PhoneNum |
| Preparation | 2019-11-02 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 172.9.161.112 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-02 | IPDt |
| IP Tm | 18:52:39 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | F565611BDA9E00D03FA055086BAA92DB14EC1355 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-04-17 16:48:07Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tillamook Regional Medical Cente | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Butler | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Third Street | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $88,258,938 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.adventisthealth.org/tillamook/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | Living God's love by inspiring health, wholeness and hope. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 657 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $135,807 | PYContributionsGrantsAmt |
| CY Contributions Grants | $180,140 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $83,609,460 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $87,209,174 | CYProgramServiceRevenueAmt |
| PY Investment Income | $497,302 | PYInvestmentIncomeAmt |
| CY Investment Income | $869,624 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$74 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $84,242,495 | PYTotalRevenueAmt |
| CY Total Revenue | $88,258,938 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $15,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $68,833 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,279,912 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $43,348,351 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $52,776 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $35,359,852 | PYOtherExpensesAmt |
| CY Other Expenses | $41,678,838 | CYOtherExpensesAmt |
| PY Total Expenses | $76,654,764 | PYTotalExpensesAmt |
| CY Total Expenses | $85,096,022 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,587,731 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,162,916 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $62,712,557 | TotalAssetsBOYAmt |
| Total Assets EOY | $65,583,470 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,774,153 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,482,150 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,938,404 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $55,101,320 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Living God's love by inspiring health, wholeness and hope. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $71,302,681 | ExpenseAmt |
| Grant | $68,833 | GrantAmt |
| Revenue | $87,209,174 | RevenueAmt |
| Desc | See Schedule O | Desc |
| Total Program Service Expenses | $71,302,681 | 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 |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 657 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | InvestmentInJointVentureInd |
| 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 | Jay Lipps VP System Controller | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9167465932 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 619135 | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Banks David | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $27,620 | $0 | |||
| Cherry Robert | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $25,126 | $0 | |||
| Davis Andrew | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $24,002 | $0 | |||
| Freedman John | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $718 | $0 | |||
| Gabriel Melody | |||||||||
| Director thru 12/2018 | 0.00 | 4.00 | Yes (X) | $0 | $20,464 | $0 | |||
| Graham Ricardo | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,442 | $0 | |||
| Heinrich Kerry | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $20,485 | $0 | |||
| Innocent Larry | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $31,885 | $0 | |||
| Pedersen James | |||||||||
| Director thru 07/2018 | 0.00 | 4.00 | Yes (X) | $0 | $3,625 | $0 | |||
| Reiner Richard | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $27,964 | $0 | |||
| Reiner Scott | |||||||||
| Dir/Chair | 0.00 | 50.00 | Yes (X) | $0 | $2,458,436 | $44,472 | Yes (X) | ||
| Rippey Wesley | |||||||||
| Director thru 05/2018, Medical Officer, PNR | 12.50 | 37.50 | Yes (X) | $0 | $623,943 | $47,568 | |||
| Salazar Velino | |||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,542 | $0 | |||
| Wing Bill | |||||||||
| Dir/Vice Chair/Asst Secr | 0.00 | 50.00 | Yes (X) | $0 | $1,875,311 | $49,315 | Yes (X) | ||
| Butler David | |||||||||
| President | 50.00 | 0.00 | $0 | $502,217 | $46,704 | Yes (X) | |||
| Jobe Meredith | |||||||||
| Secretary | 0.00 | 50.00 | $0 | $666,615 | $38,328 | Yes (X) | |||
| Smith Micah | |||||||||
| Treas/Asst Secr | 50.00 | 0.00 | $0 | $222,502 | $41,418 | Yes (X) | |||
| Wagner Jack | |||||||||
| Asst Secretary thru 03/2018 | 0.00 | 50.00 | $0 | $1,332,908 | $34,076 | Yes (X) | |||
| Leach Judy | |||||||||
| Strategy & Comm Exec, PNR | 0.00 | 50.00 | $0 | $303,187 | $31,686 | Yes (X) | |||
| Newmyer Joyce | |||||||||
| President, PNR | 12.50 | 37.50 | $0 | $1,166,598 | $42,409 | Yes (X) | |||
| Reppert Joseph | |||||||||
| CFO | 0.00 | 50.00 | $0 | $953,615 | $46,846 | Yes (X) | |||
| Saxon Kathleen | |||||||||
| PT Care Executive | 0.00 | 50.00 | $0 | $229,839 | $22,324 | Yes (X) | |||
| Seufert Regina | |||||||||
| VP Physician/Clinic Svcs | 0.00 | 50.00 | $0 | $221,285 | $21,543 | Yes (X) | |||
| Voshell Shane | |||||||||
| VP HR, PNR | 0.00 | 50.00 | $0 | $261,326 | $48,260 | Yes (X) | |||
| Welch Donald | |||||||||
| Finance Officer, PNR | 12.50 | 37.50 | $0 | $671,125 | $44,290 | Yes (X) | |||
| Kaba David | |||||||||
| Physician | 50.00 | 0.00 | $503,315 | $0 | $32,875 | Yes (X) | |||
| LaFleur Brett | |||||||||
| Physician | 50.00 | 0.00 | $533,729 | $0 | $47,229 | Yes (X) | |||
| Mitchell Brandon | |||||||||
| Physician | 50.00 | 0.00 | $410,599 | $0 | $49,705 | Yes (X) | |||
| Naidoo Abendra | |||||||||
| Physician | 50.00 | 0.00 | $456,824 | $0 | $39,704 | Yes (X) | |||
| Thompson Albert | |||||||||
| Physician | 50.00 | 0.00 | $350,953 | $0 | $28,344 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,255,420 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $11,673,780 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $757,096 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 67 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| Tillamook Emergency Services | |||||
| 1000 Third Street | Tillamook | OR | 97141 | Physician Services | $2,694,634 |
| Bivens Medical Corporation | |||||
| 20105 Geisendorfer | Applegate | CA | 95703 | Physician Services | $1,524,666 |
| Staff Care Inc | |||||
| PO BOX 281923 | Atlanta | GA | 30384 | Physician Services | $949,647 |
| Gregory Opdahl MD PC | |||||
| 4950 Clam Way West | Tillamook | OR | 97141 | Ophthomology | $668,856 |
| Rural Physicians Group | |||||
| 10624 S Eastern Avenue Ste A-263 | Henderson | NV | 89052 | Physician Services | $638,138 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $35,000 | RelatedOrganizationsAmt |
| Government Grants | $12,049 | GovernmentGrantsAmt |
| All Other Contributions | $133,091 | AllOtherContributionsAmt |
| Total Contributions | $180,140 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 900099 | $86,460,728 | $86,460,728 |
| Other revenue | 900099 | $613,720 | $613,720 |
| Dietary services | 722210 | $86,384 | $86,384 |
| Rental income | 531120 | $48,342 | $48,342 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $87,209,174 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $869,624 | TotalRevenueColumnAmt |
| Exclusion | $869,624 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,258,938 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $87,209,174 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $869,624 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,833 | TotalAmt |
| Program Services | $68,833 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,182 | TotalAmt |
| Management And General | $102,182 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,482,701 | TotalAmt |
| Program Services | $31,802,644 | ProgramServicesAmt |
| Management And General | $1,680,057 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,064,305 | TotalAmt |
| Program Services | $1,037,259 | ProgramServicesAmt |
| Management And General | $27,046 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,517,877 | TotalAmt |
| Program Services | $6,326,926 | ProgramServicesAmt |
| Management And General | $190,951 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,181,286 | TotalAmt |
| Program Services | $2,052,502 | ProgramServicesAmt |
| Management And General | $128,784 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,098,487 | TotalAmt |
| Program Services | $358,862 | ProgramServicesAmt |
| Management And General | $3,739,625 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,555 | TotalAmt |
| Management And General | $3,555 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,692 | TotalAmt |
| Management And General | $10,692 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,646 | TotalAmt |
| Program Services | $2,646 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,850,397 | TotalAmt |
| Program Services | $11,690,290 | ProgramServicesAmt |
| Management And General | $4,114,862 | ManagementAndGeneralAmt |
| Fundraising | $45,245 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,912 | TotalAmt |
| Management And General | $193,912 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $945,769 | TotalAmt |
| Program Services | $837,671 | ProgramServicesAmt |
| Management And General | $106,181 | ManagementAndGeneralAmt |
| Fundraising | $1,917 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,390,341 | TotalAmt |
| Program Services | $706,067 | ProgramServicesAmt |
| Management And General | $2,684,274 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,390,962 | TotalAmt |
| Program Services | $2,092,736 | ProgramServicesAmt |
| Management And General | $298,226 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,555 | TotalAmt |
| Program Services | $228,466 | ProgramServicesAmt |
| Management And General | $92,475 | ManagementAndGeneralAmt |
| Fundraising | $5,614 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,723 | TotalAmt |
| Program Services | $189,232 | ProgramServicesAmt |
| Management And General | $39,491 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,344 | TotalAmt |
| Program Services | $96,344 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,732,618 | TotalAmt |
| Program Services | $1,728,177 | ProgramServicesAmt |
| Management And General | $4,441 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,469 | TotalAmt |
| Program Services | $294,469 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Patient care supplies | $9,012,498 | $8,960,372 | $52,126 |
| Quality assurance (hosp | $2,812,411 | $2,812,411 | |
| Rental/leases costs, eq | $57,476 | $52,100 | $5,376 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,983 | TotalAmt |
| Program Services | -$35,326 | ProgramServicesAmt |
| Management And General | $266,309 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,096,022 | TotalAmt |
| Program Services | $71,302,681 | ProgramServicesAmt |
| Management And General | $13,740,565 | ManagementAndGeneralAmt |
| Fundraising | $52,776 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,667,188 | BOYAmt |
| EOY | $33,196,667 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,244,774 | BOYAmt |
| EOY | $11,746,970 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,717,030 | BOYAmt |
| EOY | $1,468,058 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,392 | BOYAmt |
| EOY | $120,451 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $47,192,192 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $35,339,930 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,803,902 | BOYAmt |
| EOY | $11,852,262 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $703,463 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,485,808 | BOYAmt |
| EOY | $7,199,062 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,712,557 | BOYAmt |
| EOY | $65,583,470 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,595,548 | BOYAmt |
| EOY | $6,216,390 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,178,605 | BOYAmt |
| EOY | $4,265,760 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,774,153 | BOYAmt |
| EOY | $10,482,150 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,875,169 | BOYAmt |
| EOY | $54,977,574 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,235 | BOYAmt |
| EOY | $123,746 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,938,404 | BOYAmt |
| EOY | $55,101,320 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,712,557 | BOYAmt |
| EOY | $65,583,470 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,162,916 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,646 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,646 | 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, Lobbying Activities: | FormAndLineReferenceDesc |
| Explanation | The Hospital belongs to industry and professional associations - such as the Oregon Association of Hospital and Health Systems - for which a portion of the membership dues is used for lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $63,235 | BeginningYearBalanceAmt |
| Contributions | $121,979 | ContributionsAmt |
| Grants Or Scholarships | $17,988 | GrantsOrScholarshipsAmt |
| Other Expenditures | $43,480 | OtherExpendituresAmt |
| End Year Balance | $123,746 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $41,331 | BeginningYearBalanceAmt |
| Contributions | $96,447 | ContributionsAmt |
| Grants Or Scholarships | $19,446 | GrantsOrScholarshipsAmt |
| Other Expenditures | $55,097 | OtherExpendituresAmt |
| End Year Balance | $63,235 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $697,451 | BeginningYearBalanceAmt |
| Contributions | $101,947 | ContributionsAmt |
| Other Expenditures | $758,067 | OtherExpendituresAmt |
| End Year Balance | $41,331 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,324,795 | BeginningYearBalanceAmt |
| Contributions | $159,334 | ContributionsAmt |
| Other Expenditures | $786,678 | OtherExpendituresAmt |
| End Year Balance | $697,451 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,830,000 | BeginningYearBalanceAmt |
| Contributions | $187,892 | ContributionsAmt |
| Other Expenditures | $693,097 | OtherExpendituresAmt |
| End Year Balance | $1,324,795 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,056,181 | OtherCostOrOtherBasisAmt |
| Book Value | $1,056,181 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,779,852 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,335,917 | DepreciationAmt |
| Book Value | $7,443,935 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,250,201 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,301,127 | DepreciationAmt |
| Book Value | $1,949,074 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,105,958 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,702,886 | DepreciationAmt |
| Book Value | $1,403,072 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,852,262 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Receivables from related organizations | $3,899,630 |
| Receivables from third party payors | $1,942,841 |
| Other receivables | $988,016 |
| Other assets | $368,575 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,199,062 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Payables to related organization | $3,444,000 |
| Workers' compensation liability | $723,818 |
| Other liabilities | $97,942 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,265,760 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4: | FormAndLineReferenceDesc |
| Explanation | Board-designated, temporary and permanently restricted funds are for specified operating and capital projects. The funds are released as project costs are expended. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,909,461 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,909,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03420 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,909,461 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,909,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03420 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $838,098 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $288,266 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $549,832 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $172,378 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $172,378 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $255,289 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $69 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $255,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $74,062 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $74,062 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,339,827 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $288,335 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,051,492 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,249,288 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $288,335 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,960,953 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04660 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,120 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $41,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $41,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $256,222 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $256,222 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $301,342 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $301,342 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,152,742 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $325,880 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $27,945,989 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,026,912 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $919,077 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Med Found Tillamook | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Third Street | AddressLine1Txt |
| City | Tillamook | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | adventisthealth.org/Tillamook | WebsiteAddressTxt |
| State License | 14-1177 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northwest Med Found Tillamook | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Sch H Part VI - Needs Assesment | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Sch H Part VI - Needs Assesment | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Sch H Part VI - Needs Assesment | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | Sch H Part VI-Patient Educ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | Sch H Part VI-Patient Educ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | Sch H Part VI-Patient Educ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Northwest Med Found Tillamook | Part V, Section B, Line 5: The 2016 CHNA data collection process can be summarized as follows: Review of prior CHNA reporting effortsCollection of most recently available demographic, socioeconomic and health indicator data Data gathering was accomplished by using a widely-distributed community survey, engaging with community focus groups and conducting key stakeholder interviews. Community Survey: Northwest Medical Foundation Tillamook dba Tillamook Regional Medical Center (AHTM) conducted community organization surveys that asked about the health problems and health needs of the community. The community organization survey was emailed to organizations that collaborate with AHTM in the form of an online survey. The survey addressed what community the organization serves, what is healthy in their community, what is not and what their community needs to be healthy. Twenty-five people responded to the online survey. Community Focus Groups: Twenty-eight people participated in three different focus groups. The focus groups were conducted at AHTM and at Tillamook Seventh-day Adventist Church from March 21-22, 2016. Members of the focus groups included individuals or organizations that represented the medically underserved, low-income, and minority populations served by our hospital, as well as, community members at large. Focus group participants were snowball sampled through existing support groups and classes at AHTM and leveraging of hospital administration's professional networks.Key Informant Interviews: Sixty-three people were surveyed in the form of ten key informant interviews. The groups were comprised of key leaders from an array of agencies including, local coalitions, not-for-profits, healthcare providers, and human service agencies. These were conducted by phone from February to April 2016. Key informants were identified through existing partnerships with community based organizations. Secondary data sources included publicly available state and nationally recognized data sources. Data on key health indicators, morbidity, mortality, and various social determinants of health were collected from the Census, Centers for Disease Control and Prevention, Community Commons, Nielsen, and various other state and federal databases. The quantitative data includes County specific data, and if available, data disaggregated to primary service area has been provided. When feasible, health metrics have been further compared to benchmarks, such as Healthy People 2020 objectives and State estimates. |
| Northwest Med Found Tillamook | Part V, Section B, Line 6a: None, AHTM is the only hospital in the County of Tillamook. |
| Northwest Med Found Tillamook | Part V, Section B, Line 6b: AHTM partnered with the following organizations in conducting the 2016 CHNA: Care, Inc., Complete Health Improvement Project, Manzanita Emergency Volunteer Corps, North Tillamook Emergency Preparedness, NW Regional Education Service District, The Rinehart Clinic, and the Tillamook Commission on Children & Families. |
| Northwest Med Found Tillamook | Part V, Section B, Line 11: Our 2016 CHNA identified four areas of significant needs: access to health care, chronic diseases & senior care, behavioral health & substance abuse, and children's health. The main goal was to improve the overall health and wellness of our communities through provision of services, community collaboration and innovation. Priority Need 1 - Access to Health Care - main objective: to improve top priority health care access issues through connecting uninsured patients with health insurance and financial assistance resources, recruiting and maintaining adequate numbers and types of healthcare providers, and providing services at the most appropriate level of care with navigation and follow up as needed. 2018 saw the increase in availability and access to health care through a 4.8% increase in urgent care visits and the expansion in urgent care hours. Ninety-six percent of our patients were able to be assigned a medical home in 2018. Interventions: 1. Provide uninsured patients with assistance for obtaining health insurance information and/or coverage and access to financial assistance as needed, through clinic care coordinators and financial counselors. Number of community members served - 1,241 (individuals assisted in obtaining health insurance).2. Dental Van: Free mobile dental clinic for those in need of dental services. Number of community members served - 21.3. Doc Talks: Monthly health seminars on various health topics presented by local health care providers. Talks are located at either local library or at the hospital. Healthy snacks are provided, and each talk is recorded by videographer and aired on local access channel and online. Number of community members served - 25,000.4. No cost Vaccination Van for adults and children. Number of community members served - 30.5. No cost prescription drug program. Number of community members served - 154.6. Conducted monthly grief support groups in Manzanita and Tillamook. Number of community members served - 293.7. Conducted monthly Alzheimer's support group for caregivers. Number of community members served - 43.Priority Need 2 - Chronic Diseases & Senior Care - main objective: to meet chronic health prevention needs identified by strengthening access to care, enhancing the continuum of care, supporting care coordination and navigation, and providing community wellness education that supports healthy lifestyle choices. 2018 saw 357 patients enrolled in chronic disease management plans. There were 15,801 patients visits to specialty clinics in 2018. Interventions:1. Partner with the Tillamook County Year of Wellness (YOW) to develop a strategy for community coalition to decrease the impact of diabetes on Tillamook County residents. Number of community members served - 25,000.2. Community Paramedic Program: conducts home visits for patients who are identified by our case managers and care coordinators who are at risk for readmission. Home visits consist a needs assessment, physical assessment, medication reconciliation, patient and family education, assistance with transportation and referral to our many community resources. In addition, our Community Paramedic participates in multi-disciplinary teams to help navigate patients and families to the proper resources for care with the goal of allowing the patient to remain at home. Patients can be referred to the program by our providers and community partners. This program tends to fill the gaps that may exist in the patient's continuum of care. Number of community members served - 618.3. Complete Health Improvement Program (CHIP) lifestyle wellness classes offered to community members. Number of community members served - 33.4. Serving up Hope community dinner for those who are homeless and food insecure. Number of community members served - 1,433.5. Sponsorship of early morning warm therapy pool times at Tillamook Family YMCA to enhance physical activity for people with chronic health limitations. Number of community members served - 600.Priority Need 3 - Behavioral Health & Substance Abuse - main objective: to improve top priority access points through recruitment, screening, education and community awareness. 100% of ED and Primary Care patients were screened 2018. A total of 2,298 patient visits in 2018 were seen with the addition of two full time behavioral health providers. Interventions:1. Provide Wellspring respite care for patients with cognitive impairment who reside in community care settings. Number of community members served - 137.2. Provide comprehensive medical and behavioral health care to inmates lodged in the Tillamook County Jail. Number of community members served - 342.3. Optimize Your Brain Classes: Seven Week class to cover principals of understanding brain function and how lifestyle behaviors will benefit you. Number of community members served - Seven.4. Payment of $10,000 on a three-year pledge of $25,000 to help purchase a building to house services for low-income population provided by CARE, Inc. Tillamook County's anti-poverty agency. Number of community members served - 3,000.Priority Need 4 - Children's Health - main objective: to address top priority children's health needs through early identification of risks, treatment of identified concerns, and education and outreach to parents and children. Seventy-eight children were screened for school readiness in 2018 and a 14.8% increase in the number of pediatric patient served in the primary care setting. Interventions:1. Continue leadership of annual, communitywide School Readiness for Tillamook County Kids (formerly Multi-Modular Preschool Exams) provided at no cost to all Tillamook County children ages two-six years that screens 12 areas of health and development. Number of community members served - 78.2. Pediatric Services. Number of community members served - 6,900. 3. Certified Athletic Trainer at Tillamook High School providing services to student athletes. Number of community members served - 11,375 contacts with student athletes.Priority Areas Not Addressed: For the 2017-2019 Community Health Plan (implementation strategy), the Hospital has elected to adopt a broad strategy that addresses all the priority needs identified. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 12 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - AH Tillamook Medical Group | ||||
| 980 Third Street | Tillamook | OR | 97141 | Outpatient clinic |
| 2 - AH Tillamook Women and Family Facility | ||||
| 1011 Third Street | Tillamook | OR | 97141 | Outpatient clinic |
| 3 - Manzanita Primary & Specialty Care | ||||
| 10445 Neahkahnie Creek Road | Manzanita | CA | 97130 | Rural health clinic |
| 4 - Bayshore Family Medicine | ||||
| 38505 Brooten Road Suite A | Pacific City | OR | 97135 | Rural health clinic |
| 5 - Bayshore Family Medicine | ||||
| 1105 SE Jetty Avenue Suite C | Lincoln City | OR | 97367 | Rural health clinic |
| 6 - Adventist Health Banks | ||||
| 1235 NW Main Suite 112 | Banks | OR | 97106 | Rural health clinic |
| 7 - Adventist Health TillamookMedical Group-E | ||||
| 103 SW Highway 224 Suite B | Estacada | OR | 97023 | Rural health clinic |
| 8 - Adventist Health TillamookMedical Group-H | ||||
| 24461 E Welches Road | Welches | OR | 97067 | Rural health clinic |
| 9 - Tillamook Medical Plaza | ||||
| 1100 Third Street | Tillamook | OR | 97141 | Outpatient clinic |
| 10 - Adventist Health - Vernonia | ||||
| 1005 Cougar Street | Tillamook | OR | 97064 | Rural health clinic |
| 11 - Specialty Clinic - Occupational Therapy | ||||
| 980 Third Street | Tillamook | OR | 97141 | Outpatient clinic |
| 12 - Adventist Health Medical Group Surgery Ser | ||||
| 980 Third Street Suite 100 | Tillamook | OR | 97141 | Outpatient clinic |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows:(Total expenses - (Provision for bad debts + Other revenue + Interest income)) / Gross patient charges |
| Part II, Community Building Activities: | The Hospital is involved in numerous community building activities that promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. |
| Part III, Line 2: | Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. |
| Part III, Line 3: | The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. |
| Part III, Line 4: | The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. |
| Part III, Line 8: | The Medicare cost report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology. Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care. In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the Hospital's Medicare Cost Report to GL*Medicare Cost Report Revenue 27,945,989Prior Year Settlements 207,713Cost Report Reimbursable Bad Debts 68,710Estimates and Accrual Variances 304,980 Other 2,161,588Total Medicare Revenue 30,688,980*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. |
| Part III, Line 9b: | When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest |
| Part VI, Line 2: | The Hospital's 2016 CHNA, the 2019 Community Health Plan (CHP) Update for fiscal year 20108, the 2018 Community Health Plan (CHP) Update for fiscal year 2017, and the 2016 Implementation Strategy (adopted in May 2017), which includes the 2016 CHP, are posted on the Hospital's website at:https://www.adventisthealth.org/about-us/community-benefit/The CHNA, Implementation Strategy, and the CHPs are also available on the Adventist Health Corporate website at: https://www.adventisthealth.org/about-us/community-benefit/Hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. Committee/Board Participation includes: NW Regional Education Service District; Head Start Child and Family Development Program; Community Action Resource Enterprises (CARE, Inc.); Oregon Food Bank-Tillamook County Services; Food, Education, Agriculture, Solutions Together (FEAST); Tillamook Seventh-day Adventist Church; North County Food Bank-Nehalem; Tillamook Family Counseling Center; Northwest Oregon Regional Housing Center; and others. |
| Part VI, Line 3: | The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/financial-assistance/These documents are available in multiple languages. At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the Hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. |
| Part VI, Line 4: | AHTM's service area is all of Tillamook County, which contains three geographic areas: Nehalem (North), Tillamook (Central), and Cloverdale (South). In addition to serving patients at the hospital, patients are also served at the five rural health clinics in our network. In the primary service area, the current year population is approximately 25,000. The largest age group is comprised of persons aged 45-64 years, with a median age of 49.2 compared to the U.S. median age of 37.9. The population is primarily composed of individuals who identify as White (89.8%) and the smallest group is composed of individuals who identify as Pacific Islander (0.3%) followed by African Americans (0.5%). In terms of ethnicity, 12.2% of the population is of Hispanic origin. English is the dominant language spoken in the service area. The percent of the population older than five years old that speaks English less than "very well" is low in the primary service area at 6% for Nehalem, 0.5% for Cloverdale, and 2.8% for Tillamook. The median income for all households is $43,037 which is lower than both the State of Oregon ($50,521) and the U.S. ($53,046). 29.2% of household in the area have an annual income of less than $25,000 compared to 24.1% for Oregon State and 23.4% for the U.S. |
| Part VI, Line 5: | Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope."Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities. Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders.As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy.Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population;2) Factors that cause the present outcomes distribution; and3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to:1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors,2) Improve care quality and patient safety, and3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. |
| Part VI, Line 6: | The Hospital is a member of Adventist Health System/West, a health care system that provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as tele pharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. |
| Part VI, Line 7, Reports Filed With States | OR |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| CARE | ||||||||||
| 2310 First Street Suite 2 | Tillamook | OR | 97141 | 931062448 | 501(c)(3) | $10,000 | "Home for Care" Capital Campaign | |||
| Tillamook County Community Health CentersTillamook County Wellness | ||||||||||
| PO Box 489 | Tillamook | OR | 97141 | 936002312 | Gov't | $30,000 | Prevention of Chronic Disease-Diabetes | |||
| Tillamook Seventh-day Adventist Church | ||||||||||
| 2610 1st Street | Tillamook | OR | 97141 | 264220036 | 501(c)(3) | $0 | Wellness Education-Prevention of Chronic Diseases | $7,833 | Invoice | Education equipment |
| Tillamook County Community Health Centers | ||||||||||
| PO Box 489 | Tillamook | OR | 97141 | 936002312 | Gov't | $0 | Prevention of Chronic Disease-Diabetes | $5,500 | Invoice | Retinavue equipment |
| The Rinehart Clinic | ||||||||||
| PO Box 176 | Wheeler | OR | 97147 | 931191794 | 501(c)(3) | $0 | Prevention of Chronic Disease-Diabetes | $5,500 | Invoice | Retinavue equipment |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Grants and other assistance are made in response to specific requests and identified need by community groups and nonprofits. A letter restricting use of the granted funds to the purpose mutually agreed is sent with each cash donation. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 | 0 | 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 (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reiner Scott | ||||||||||||||
| Dir/Chair | $0 | $1,339,257 | $0 | $747,881 | $0 | $371,298 | $0 | $16,682 | $0 | $27,790 | $0 | $2,502,908 | $0 | $289,242 |
| Rippey Wesley | ||||||||||||||
| Director thru 05/2018, Medical Offic | $0 | $565,539 | $0 | $0 | $0 | $58,404 | $0 | $20,249 | $0 | $27,319 | $0 | $671,511 | $0 | $0 |
| Wing Bill | ||||||||||||||
| Dir/Vice Chair/Asst Secr | $0 | $1,015,353 | $0 | $603,273 | $0 | $256,685 | $0 | $16,682 | $0 | $32,633 | $0 | $1,924,626 | $0 | $191,758 |
| Butler David | ||||||||||||||
| President | $0 | $301,537 | $0 | $98,200 | $0 | $102,480 | $0 | $16,682 | $0 | $30,022 | $0 | $548,921 | $0 | $34,997 |
| Jobe Meredith | ||||||||||||||
| Secretary | $0 | $419,684 | $0 | $111,013 | $0 | $135,918 | $0 | $16,682 | $0 | $21,646 | $0 | $704,943 | $0 | $59,224 |
| Smith Micah | ||||||||||||||
| Treas/Asst Secr | $0 | $157,339 | $0 | $11,496 | $0 | $53,667 | $0 | $11,914 | $0 | $29,504 | $0 | $263,920 | $0 | $0 |
| Wagner Jack | ||||||||||||||
| Asst Secretary thru 03/2018 | $0 | $180,671 | $0 | $414,342 | $0 | $737,895 | $0 | $11,182 | $0 | $22,894 | $0 | $1,366,984 | $0 | $0 |
| Leach Judy | ||||||||||||||
| Strategy & Comm Exec, PNR | $0 | $237,547 | $0 | $48,964 | $0 | $16,676 | $0 | $16,682 | $0 | $15,004 | $0 | $334,873 | $0 | $0 |
| Newmyer Joyce | ||||||||||||||
| President, PNR | $0 | $657,199 | $0 | $294,310 | $0 | $215,089 | $0 | $16,682 | $0 | $25,727 | $0 | $1,209,007 | $0 | $115,201 |
| Reppert Joseph | ||||||||||||||
| CFO | $0 | $686,470 | $0 | $152,446 | $0 | $114,699 | $0 | $16,682 | $0 | $30,164 | $0 | $1,000,461 | $0 | $0 |
| Saxon Kathleen | ||||||||||||||
| PT Care Executive | $0 | $178,481 | $0 | $28,022 | $0 | $23,336 | $0 | $11,862 | $0 | $10,462 | $0 | $252,163 | $0 | $0 |
| Seufert Regina | ||||||||||||||
| VP Physician/Clinic Svcs | $0 | $170,839 | $0 | $26,352 | $0 | $24,094 | $0 | $11,538 | $0 | $10,005 | $0 | $242,828 | $0 | $0 |
| Voshell Shane | ||||||||||||||
| VP HR, PNR | $0 | $189,911 | $0 | $40,615 | $0 | $30,800 | $0 | $14,265 | $0 | $33,995 | $0 | $309,586 | $0 | $0 |
| Welch Donald | ||||||||||||||
| Finance Officer, PNR | $0 | $398,127 | $0 | $97,502 | $0 | $175,496 | $0 | $16,682 | $0 | $27,608 | $0 | $715,415 | $0 | $93,616 |
| Kaba David | ||||||||||||||
| Physician | $502,324 | $0 | $0 | $0 | $991 | $0 | $16,682 | $0 | $16,193 | $0 | $536,190 | $0 | $0 | $0 |
| LaFleur Brett | ||||||||||||||
| Physician | $532,738 | $0 | $0 | $0 | $991 | $0 | $11,182 | $0 | $36,047 | $0 | $580,958 | $0 | $0 | $0 |
| Mitchell Brandon | ||||||||||||||
| Physician | $385,627 | $0 | $8,270 | $0 | $16,702 | $0 | $16,682 | $0 | $33,023 | $0 | $460,304 | $0 | $0 | $0 |
| Naidoo Abendra | ||||||||||||||
| Physician | $454,544 | $0 | $0 | $0 | $2,280 | $0 | $16,682 | $0 | $23,022 | $0 | $496,528 | $0 | $0 | $0 |
| Thompson Albert | ||||||||||||||
| Physician | $339,932 | $0 | $3,352 | $0 | $7,669 | $0 | $16,682 | $0 | $11,662 | $0 | $379,297 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Lines 4a-b | FormAndLineReferenceDesc |
| Explanation | Severance payments are made based upon agreements between certain qualifying employees and Adventist Health Services/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Wagner, Jack - severance payment - $598,810 The Supplemental Executive Retirement Plan (SERP) is a defined contribution plan designed to encourage the participants continued employment with Adventist Health and is subject to the participants satisfying specified substantial risks of forfeiture. The SERP benefit distribution occurs when the executive achieves 30 years of Adventist health care service, 20 of which are to be as an executive and at least 10 are to be with Adventist Health System/West, and reaches age 60. Until that time, the SERP benefit is at risk to the creditors of Adventist Health. The SERP benefit is designed to help the executive receive employer-provided retirement benefit income equal to 60% of pre-retirement income. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. Butler, David - $34,997 Jobe, Meredith - $59,224 Newmyer, Joyce - $115,201 Reiner, Scott - $289,242 Welch, Donald - $93,616 Wing, Bill - $191,758 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Charles Saxon | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family member of Key EE, K. Saxon | RelationshipDescriptionTxt |
| Transaction | $102,182 | TransactionAmt |
| Transaction | Employment | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4a | Northwest Medical Foundation Tillamook dba Tillamook Regional Medical Center (AHTM) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability AHTM, the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay: - providing free care and/or subsidized care - providing care to persons covered by governmental programs at below cost - providing health/wellness activities and community education programs Not only does AHTM provide low cost care to individuals covered by government-programs and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. AHTM recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2018 was $2,909,461. The following Inpatient services that were provided to all our patients. These services included: - 176 Babies delivered - 272 Surgeries performed - 4,494 Patient days The following Outpatient services that were provided to all our patients. These services included: - 10,950 Emergency department visits - 85,437 Outpatient surgeries performed - 85,437 Outpatient visits - 96,283 Clinic visits AHTM recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2018 was $1,051,493. Adventist Health's mission statement of Living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry as represented by the life of Jesus Christ and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ |
| Form 990, Part VI, Section A, line 6 | The Hospital is organized as a public benefit corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit public benefit corporation that operates as a public charity. The Hospital operates as an affiliate of Adventist Health System/West. |
| Form 990, Part VI, Section A, line 7a | The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. |
| Form 990, Part VI, Section A, line 7b | The sole corporate member, Adventist Health System/West, must approve all changes to the Articles of Incorporation and Bylaws. |
| Form 990, Part VI, Section B, line 11b | This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the System Controller and Market Finance Officer, and shared by electronic communication with the Hospital's Board of Directors prior to filing. |
| Form 990, Part VI, Section B, line 12c | During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The Corporate General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The Corporate General Counsel reviews all the disclosures on the board and Corporate employees' COIs. Corporate General Counsel retains the COIs for the board members. The officers and key employees' COIs are kept in their personnel files. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. |
| Form 990, Part VI, Section B, line 15 | The Hospital Board of Directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. A hospital CEO has a maximum potential incentive of 30 or 35 percent of base salary based upon size and scope of hospital. (Incentive potential is industry norm) Other hospital executives have a maximum potential incentive of 25 to 30 percent of base salary. |
| Form 990, Part VI, Section C, line 19 | The Hospital does not make its governing documents publicly available beyond required filings of Articles of Incorporation and Bylaws with the Oregon Secretary of State and Oregon Department of Justice. The Hospital does not make its Conflict of Interest Policy publicly available. The Hospital files monthly/quarterly summary financial reports with the Oregon Health Authority. |
| Form 990, Part IX, line 11g | Physician professional fees: Program service expenses 7,321,810. Management and general expenses 1,800. Fundraising expenses 0. Total expenses 7,323,610. Other medical professional fees: Program service expenses 90,037. Management and general expenses 0. Fundraising expenses 0. Total expenses 90,037. Consulting and other management fees: Program service expenses 49,933. Management and general expenses 103,840. Fundraising expenses 0. Total expenses 153,773. Other professional fees non-medical: Program service expenses 183,656. Management and general expenses 78,487. Fundraising expenses 0. Total expenses 262,143. Contract labor: Program service expenses 1,445,329. Management and general expenses 65,586. Fundraising expenses 0. Total expenses 1,510,915. Purchased medical services: Program service expenses 332,139. Management and general expenses 1,755. Fundraising expenses 0. Total expenses 333,894. Repairs and maintenance: Program service expenses 677,858. Management and general expenses 1,091. Fundraising expenses 0. Total expenses 678,949. All other purchased services: Program service expenses 1,591,905. Management and general expenses 104,454. Fundraising expenses 45,245. Total expenses 1,741,604. Revenue cycle fees: Program service expenses -2,377. Management and general expenses 3,757,849. Fundraising expenses 0. Total expenses 3,755,472. |
| Form 990, Part VII: | In recognition of the time commitment directors make to serve on the Adventist Health System/West boards and committees, directors receive compensation when their employment agreements with their employers allow such payments. For those whose employers do not allow accepting compensation for board service, the funds are directly distributed to charitable organizations as mandated by their employment agreements. In addition, amounts paid for taxable benefits are also reported. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Adventist Health Clearlake Hospital Inc | |||||||||||
| 15630 18th Avenue | Clearlake | CA | 95422 | 680395149 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Adventist Health Medical Center Tehachapi | |||||||||||
| 1100 Magellan Drive | Tehachapi | CA | 93561 | 812240617 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Adventist Health Physicians Network | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 680357690 | Medical foundation | CA | 501(c)(3) | Line 12b, II | Adventist Health SystemWest | 0 | |
| Adventist Health SystemWest | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 953484589 | Integrated health system | CA | 501(c)(3) | Line 10 | 0 | N/A | |
| Castle Medical Center | |||||||||||
| 640 Ulukahiki Street | Kailua | HI | 96734 | 990107330 | Hospital | HI | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Feather River Hospital | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 941101228 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Fremont-Rideout Health Group | |||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 942917251 | Acute care hospital | CA | 501(c)(3) | Line 12b, II | Stone Point Health | 0 | |
| Glendale Adventist Medical Center | |||||||||||
| 1509 Wilson Terrace | Glendale | CA | 91206 | 951816017 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Hanford Community Hospital | |||||||||||
| 115 Mall Drive | Hanford | CA | 93230 | 940535360 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Lodi Memorial Hospital Association Inc | |||||||||||
| 975 S Fairmont Avenue | Lodi | CA | 95240 | 941044474 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Paradise Valley Hospital | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 951816034 | Discontinued operations | CA | 501(c)(3) | Line 1 | Adventist Health SystemWest | 0 | |
| Portland Adventist Medical Center | |||||||||||
| 10123 SE Market Street | Portland | OR | 97216 | 930429015 | Hospital | OR | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Reedley Community Hospital | |||||||||||
| 372 Cypress Avenue | Reedley | CA | 93654 | 453220509 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Rideout Memorial Hospital | |||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 941387866 | Acute care hospital | CA | 501(c)(3) | Line 3 | Fremont-Rideout Health Group | 0 | |
| St Helena Hospital | |||||||||||
| 10 Woodland Road | St Helena | CA | 94574 | 941279779 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| San Joaquin Community Hospital | |||||||||||
| 2615 Chester Avenue | Bakersfield | CA | 93301 | 952294234 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Simi Valley Hospital & Health Care Services | |||||||||||
| 2975 N Sycamore Drive | Simi Valley | CA | 93065 | 956064971 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Sonora Community Hospital | |||||||||||
| 1000 Greenley Road | Sonora | CA | 95370 | 941415069 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Stone Point Health | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 823763347 | Supporting organization | CA | 501(c)(3) | Line 12b, II | Adventist Health SystemWest | 0 | |
| Ukiah Adventist Hospital | |||||||||||
| 275 Hospital Drive | Ukiah | CA | 95482 | 941639901 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| United Com-Serve | |||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 943015356 | Skilled nursing/assisted living/home health | CA | 501(c)(3) | Line 12b, II | Fremont-Rideout Health Group | 0 | |
| Walla Walla General Hospital | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 910617726 | Hospital - closed July 2017 | WA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Western Health Resources | |||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 953867863 | Home care | CA | 501(c)(3) | Line 10 | Adventist Health SystemWest | 0 | |
| White Memorial Medical Center | |||||||||||
| 1720 Cesar E Chavez Avenue | Los Angeles | CA | 90033 | 952282647 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Willits Hospital Inc | |||||||||||
| 1 Marcela Drive | Willits | CA | 95490 | 680108919 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Coast Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 619135 | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952037291 | EIN |
| Primary Activities | Wind down after sale of hospital | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |