STRATEGY STUDIO / PUBLIC DATA EXPLORER

GOOD SHEPHERD HEALTH CARE SYSTEM: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
GOOD SHEPHERD HEALTH CARE SYSTEM (EIN 93-0425580)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-10
IRS object ID
201931309349305318
Schema version
2017v2.3
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-10T17:42:45-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN200079326PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DINGUS ZARECOR & ASSOCIATES PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line112015 E MAIN AVEAddressLine1Txt
CitySPOKANE VALLEYCityNm
State AbbreviationWAStateAbbreviationCd
ZIP99206ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930425580EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD HEALTH CARE SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGOODBusinessNameControlTxt
Phone5416673400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11TH STREETAddressLine1Txt
CityHERMISTONCityNm
State AbbreviationORStateAbbreviationCd
ZIP97838ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDENNIS BURKEPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone5416673400PhoneNum
Signature2019-05-03SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS DINGUSPreparerPersonNm
PTINP00951009PTIN
Phone5092420874PhoneNum
Preparation2019-05-10PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address63.131.236.90IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-05-10IPDt
IP Tm17:42:45IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdAB0260C9A42DF407710DF0D66D93E7824888E325AtSubmissionCreationDeviceId
At Submission Filing Device Id2474EFBFE268E1323248D70D812BABF32F861C74AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDENNIS BURKEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11TH STREETAddressLine1Txt
CityHERMISTONCityNm
State AbbreviationORStateAbbreviationCd
ZIP97838ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$107,904,557GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GSHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1953FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE AND TO PROMOTE A HEALTHY COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee836TotalEmployeeCnt
Total Volunteers68TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$697,641PYContributionsGrantsAmt
CY Contributions Grants$552,378CYContributionsGrantsAmt
PY Program Service Revenue$94,046,668PYProgramServiceRevenueAmt
CY Program Service Revenue$98,087,823CYProgramServiceRevenueAmt
PY Investment Income$7,541,014PYInvestmentIncomeAmt
CY Investment Income$7,786,185CYInvestmentIncomeAmt
PY Other Revenue$1,646,381PYOtherRevenueAmt
CY Other Revenue$1,420,130CYOtherRevenueAmt
PY Total Revenue$103,931,704PYTotalRevenueAmt
CY Total Revenue$107,846,516CYTotalRevenueAmt
PY Grants And Similar Paid$886,254PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,017,301CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$49,409,274PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,149,670CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$162,283CYTotalFundraisingExpenseAmt
PY Other Expenses$37,308,815PYOtherExpensesAmt
CY Other Expenses$42,229,608CYOtherExpensesAmt
PY Total Expenses$87,604,343PYTotalExpensesAmt
CY Total Expenses$97,396,579CYTotalExpensesAmt
PY Revenues Less Expenses$16,327,361PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,449,937CYRevenuesLessExpensesAmt
Total Assets BOY$193,381,087TotalAssetsBOYAmt
Total Assets EOY$204,208,452TotalAssetsEOYAmt
Total Liabilities BOY$11,045,230TotalLiabilitiesBOYAmt
Total Liabilities EOY$13,234,980TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$182,335,857NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$190,973,472NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE COMPASSIONATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE AND TO PROMOTE A HEALTHY COMMUNITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$85,265,908ExpenseAmt
Grant$1,017,301GrantAmt
Revenue$98,087,823RevenueAmt
DescGOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) SERVED 1,576 INPATIENTS OVER 4,339 PATIENT DAYS, 67,381 OUTPATIENTS, AND 20,690 PATIENTS IN OUR EMERGENCY CENTER DURING FISCAL YEAR 2017-2018. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF GSHCS, NOT ALL INDIVIDUALS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. GSHCS PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT DEEPLY DISCOUNTED RATES AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 4,254,719 WRITTEN OFF AS BAD DEBT, AND AN ADDITIONAL 4,998,603 OF DIRECT CHARITY CARE TO OUR COMMUNITY. RECOGNIZING OUR MISSION TO THE COMMUNITY, SERVICES WERE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS DURING THE YEAR WAS 45,047,106. THE UNREIMBURSED AMOUNTS ARE VALUED AT CHARGES FOREGONE. OUR EMERGENCY CENTER IS OPEN AROUND-THE-CLOCK TO ALL COMMUNITY MEMBERS, VISITORS, AND TRAVELERS, WITHOUT REGARD TO ONE'S ABILITY TO PAY.Desc
Total Program Service Expenses$85,265,908TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document192IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee836EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAN PETERPersonNm
Phone5416673400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11TH STREETAddressLine1Txt
CityHERMISTONCityNm
State AbbreviationORStateAbbreviationCd
ZIP97838ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
STEVE ELDRIGE
CHAIR2.00Yes (X)Yes (X)$0$0$0
NANCY MABRY
VICE CHAIR2.00Yes (X)Yes (X)$0$0$0
DEREK EARL
SECRETARY2.00Yes (X)Yes (X)$0$0$0
TOM WAMSLEY
TREASURER2.00Yes (X)Yes (X)$0$0$0
BOB CARLSON
DIRECTOR2.00Yes (X)$0$0$0
ARNELL EYNON
DIRECTOR2.00Yes (X)$0$0$0
RACHEL ARCHER
DIRECTOR2.00Yes (X)$0$0$0
GLENN YOUNGMAN
DIRECTOR2.00Yes (X)$0$0$0
BILL ELFERING
DIRECTOR2.00Yes (X)$0$0$0
SUE DAGGETT
DIRECTOR2.00Yes (X)$0$0$0
JANET COOLEY
DIRECTOR2.00Yes (X)$0$0$0
GABINO GISPERT
DIRECTOR2.00Yes (X)$0$0$0
DENNIS BURKE
PRESIDENT/CE40.00Yes (X)$447,067$0$49,981
JAN PETER
CFO40.00Yes (X)$240,556$0$43,930
JIM SCHLENKER
COO40.00$227,430$0$30,016Yes (X)
JEREMY ANDERSON
ORTHO40.00$583,319$0$14,334Yes (X)
THOMAS HOLT
UROLOGIST40.00$347,000$0$31,993Yes (X)
CHRISTOPHER KEELER
SURGEON40.00$319,349$0$19,427Yes (X)
LEONIDEZ DE GUZMAN
HOSPITALIST40.00$318,641$0$29,404Yes (X)
LEILA KEELER
OB/GYN40.00$309,225$0$45,389Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,792,587TotalReportableCompFromOrgAmt
Total Other Compensation$264,474TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K98IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NORTHWEST EMERGENCY PHYSICIANS
PO BOX 634850CINCINNATIOH45263ER PHYSICIANS$3,029,782
REHAB ASSOCIATES
600 NW 11TH STREET SUITE E31HERMISTONOR97838PHYSICAL THERAP$1,589,870
TUALATIN IMAGING
7427 SW COHO CT SUITE 200TUALATINOR97062DIAGNOSTIC IMAG$1,288,793
LOCUMTENENSCOM
PO BOX 405547ATLANTAGA30384LOCUM SERVICES$938,259
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397LOCUM SERVICES$410,229
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$31,953RelatedOrganizationsAmt
Government Grants$215,622GovernmentGrantsAmt
All Other Contributions$304,803AllOtherContributionsAmt
Total Contributions$552,378TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE624100$98,024,276$98,024,276
SUPPORTING PATIENT SERVICES624100$63,547$63,547
FieldValueIRS element (for citing)
Total Program Service Revenue$98,087,823TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,862,762TotalRevenueColumnAmt
Exclusion$4,862,762ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$11,250RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$11,250RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,250TotalRevenueColumnAmt
Exclusion$11,250ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,893,464SecuritiesAmt
Other$88,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$58,041OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,893,464SecuritiesAmt
Other$29,959OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,923,423TotalRevenueColumnAmt
Exclusion$2,923,423ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA722210$828,283$828,283
PATIENT FINANCE900099$288,408$288,408
DAYCARE624410$258,031$258,031

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,158TotalRevenueColumnAmt
Exclusion$34,158ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,408,880OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$107,846,516TotalRevenueColumnAmt
Related Or Exempt Func Income$98,087,823RelatedOrExemptFuncIncomeAmt
Exclusion$9,206,315ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$976,019TotalAmt
Program Services$976,019ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$41,282TotalAmt
Program Services$41,282ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,061,766TotalAmt
Management And General$1,061,766ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$42,227,869TotalAmt
Program Services$34,953,767ProgramServicesAmt
Management And General$7,177,719ManagementAndGeneralAmt
Fundraising$96,383FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,687,778TotalAmt
Program Services$1,562,603ProgramServicesAmt
Management And General$120,866ManagementAndGeneralAmt
Fundraising$4,309FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,590,950TotalAmt
Program Services$5,403,020ProgramServicesAmt
Management And General$1,173,031ManagementAndGeneralAmt
Fundraising$14,899FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,581,307TotalAmt
Program Services$2,090,732ProgramServicesAmt
Management And General$484,810ManagementAndGeneralAmt
Fundraising$5,765FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$50,268TotalAmt
Management And General$50,268ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$66,161TotalAmt
Management And General$66,161ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$210,296TotalAmt
Management And General$210,296ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$14,974,367TotalAmt
Program Services$12,965,656ProgramServicesAmt
Management And General$1,998,449ManagementAndGeneralAmt
Fundraising$10,262FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$313,107TotalAmt
Program Services$27,968ProgramServicesAmt
Management And General$283,927ManagementAndGeneralAmt
Fundraising$1,212FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,261,768TotalAmt
Program Services$4,684,523ProgramServicesAmt
Management And General$575,170ManagementAndGeneralAmt
Fundraising$2,075FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,846,096TotalAmt
Program Services$3,787,336ProgramServicesAmt
Management And General$58,760ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$869,513TotalAmt
Program Services$765,488ProgramServicesAmt
Management And General$101,633ManagementAndGeneralAmt
Fundraising$2,392FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$597,240TotalAmt
Program Services$423,099ProgramServicesAmt
Management And General$174,141ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$166,303TotalAmt
Program Services$424ProgramServicesAmt
Management And General$165,879ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,919TotalAmt
Program Services$1,919ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,294,713TotalAmt
Program Services$5,294,158ProgramServicesAmt
Management And General$987,530ManagementAndGeneralAmt
Fundraising$13,025FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$591,588TotalAmt
Program Services$447,401ProgramServicesAmt
Management And General$144,187ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES & DRUGS$8,179,071$8,179,071
RECRUITMENT$461,849$448,544$13,305
OTHER EXPENSES$201,265$103,536$97,729
DUES AND SUBCRIPTIONS$144,084$59,360$84,689$35

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Program Services$3,050,002ProgramServicesAmt
Management And General-$3,061,928ManagementAndGeneralAmt
Fundraising$11,926FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$97,396,579TotalAmt
Program Services$85,265,908ProgramServicesAmt
Management And General$11,968,388ManagementAndGeneralAmt
Fundraising$162,283FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,251,951BOYAmt
EOY$7,439,034EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,141,288BOYAmt
EOY$16,951,080EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$2,464,124BOYAmt
EOY$2,874,719EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,289,499BOYAmt
EOY$3,233,750EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,211,412BOYAmt
EOY$1,077,487EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$135,253,614LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$69,222,145LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$62,711,977BOYAmt
EOY$66,031,469EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$87,437,170BOYAmt
EOY$92,140,209EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$630,000BOYAmt
EOY$630,000EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$8,495,732BOYAmt
EOY$8,805,510EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,747,934BOYAmt
EOY$5,025,194EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$193,381,087BOYAmt
EOY$204,208,452EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,843,111BOYAmt
EOY$10,213,526EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$202,119BOYAmt
EOY$3,021,454EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,045,230BOYAmt
EOY$13,234,980EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$181,631,124BOYAmt
EOY$190,508,699EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$704,733BOYAmt
EOY$464,773EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$182,335,857BOYAmt
EOY$190,973,472EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$193,381,087BOYAmt
EOY$204,208,452EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$10,449,937ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$200,721NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,013,043OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$13,127OtherActivitiesAmt
Total Lobbying Expenditures$13,127TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationTHE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$2,860,961InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$951,448OtherCostOrOtherBasisAmt
Book Value$3,812,409BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$76,024,162OtherCostOrOtherBasisAmt
Depreciation$27,444,868DepreciationAmt
Book Value$48,579,294BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,439,014OtherCostOrOtherBasisAmt
Depreciation$1,643,547DepreciationAmt
Book Value$795,467BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$52,838,912OtherCostOrOtherBasisAmt
Depreciation$40,133,730DepreciationAmt
Book Value$12,705,182BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$139,117OtherCostOrOtherBasisAmt
Book Value$139,117BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$66,031,469TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
INSURANCE PAYABLES$2,575,056
THIRD-PARTY SETTLEMENTS$400,000
CAPITAL LEASE OBLIGATIONS$46,398
FieldValueIRS element (for citing)
Total Liability$3,021,454TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationGSHCS IS EXEMPT FROM FEDERAL INCOME TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. GSHCS EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2018 AND 2017, GSHCS HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,899,190TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,899,190NetCommunityBenefitExpnsAmt
Total Expense0.02980TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,151,089TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,612,511DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,538,578NetCommunityBenefitExpnsAmt
Total Expense0.02610TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,050,279TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,612,511DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,437,768NetCommunityBenefitExpnsAmt
Total Expense0.05580TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served15819PersonsServedCnt
Total Community Benefit Expns$569,673TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$63,246DirectOffsettingRevenueAmt
Net Community Benefit Expns$506,427NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$310,290TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$302,790NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,387,566TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,762,737DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,624,829NetCommunityBenefitExpnsAmt
Total Expense0.08860TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$938,219TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$938,219NetCommunityBenefitExpnsAmt
Total Expense0.00960TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served15819PersonsServedCnt
Total Community Benefit Expns$28,205,748TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,833,483DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,372,265NetCommunityBenefitExpnsAmt
Total Expense0.10650TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served15819PersonsServedCnt
Total Community Benefit Expns$55,256,027TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$39,445,994DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,810,033NetCommunityBenefitExpnsAmt
Total Expense0.16230TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,488,877BadDebtExpenseAmt
Bad Debt Expense Attributable$46,006BadDebtExpenseAttributableAmt
Reimbursed By Medicare$24,194,056ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$26,141,160CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,947,104MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD HEALTH CARE SYSTEMBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11TH STREETAddressLine1Txt
CityHERMISTONCityNm
State AbbreviationORStateAbbreviationCd
ZIP97838ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.GSHEALTH.ORGWebsiteAddressTxt
State License055598-6StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD HEALTH CARE SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.GSHEALTH.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART VIStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART VFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART VFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART VFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 3EIDENTIFICATION OF HEALTH NEEDS ARE ADDRESSED IN SECTION 1, OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE.
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 5THE NEEDS ASSESSMENT WAS ENVISIONED, DESIGNED, AND EXECUTED BY COMMUNITY LEADERS AND MEMBERS REPRESENTING HEALTHCARE, PUBLIC HEALTH, LAW ENFORCEMENT, EDUCATION, AND SOCIAL SERVICES. THE ASSESSMENT WAS CONDUCTED IN PARTNERSHIP WITH ST. ANTHONY HOSPITAL IN PENDLETON, OR. THE ASSESSMENT PROCESS INCLUDED REGULAR CONSULTATION WITH THE LOCAL CHILD DEVELOPMENT COALITION AND COUNTY PUBLIC HEALTH DEPARTMENTS. A TOTAL OF 2,400 SURVEYS WERE MAILED TO RESIDENTS OF UMATILLA AND MORROW COUNTIES TARGETING ADULTS 19-YEARS-OF-AGE AND OLDER.
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 6ATHE CHNA WAS CONDUCTED WITH ST. ANTHONY HOSPITAL LOCATED IN PENDLETON, OR.
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 6BTHE CHNA WAS ALSO CONDUCTED WITH OREGON CHILD DEVELOPMENT COALITION, MORROW COUNTY PUBLIC HEALTH, AND UMATILLA COUNTY PUBLIC HEALTH.
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 7DTHE CHNA WAS MADE WIDELY AVAILABLE THROUGH A NEWSPAPER ARTICLE PROVIDING A SYNOPSIS OF THE ASSESSMENT'S FINDINGS, AS WELL AS PUBLIC FORUMS DISCUSSING THE ASSESSMENT'S FINDINGS.
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 11THE FOLLOWING PRIORITIZED HEALTH NEEDS WERE DETERMINED BY CHNAS FOR UMATILLA AND MORROW COUNTIES, ALONG WITH THEIR CURRENT MITIGATION STRATEGIES: 1. OBESITY: HEALTHY COMMUNITIES COALITION PROVIDED NUTRITIONAL GUIDELINE PRESENTATIONS IN SCHOOLS AND WORKPLACES, ALONG WITH AD HOC COMMUNITY NUTRITION CLASSES. 2. TOBACCO/DRUG/ACHOHOL ADDICTION: PROMOTING QUIT LINE AND EDUCATING THE COMMUNITY ON WHY THEY SHOULD QUIT. GOOD SHEPHERD ESTABLISHED A PAIN CLINIC WITH A PAIN CONTROL SPECIALIST AND ALSO REGULARLY OFFERS TOBACCO CESSATION CLASSES AND SUPPORT. 3. MENTAL HEALTH: IMPLEMENTING DEPRESSION SCREENING ACTIVITIES AND FOLLOW UP REFERRALS. GOOD SHEPHERD PROVIDES CORPORATE SUPPORT THROUGH A FRIENDSHIP LEASE OF LAND TO LIFEWAY'S ACUTE INPATIENT MENTAL HEALTH CENTER IN HERMISTON. 4. VIOLENCE/SAFETY: PROMOTING VIOLENCE PREVENTION ADVISORY COUNCIL AND EDUCATING THE COMMUNITY AND SCHOOLS. 5. CHRONIC DISEASE: GOOD SHEPHERD OFFERS A DIABETES EDUCATION PROGRAM OPEN TO THE PUBLIC WITHOUT RESTRICTIONS ON ABILITY TO PAY AND PROVIDES FREE AND DISCOUNTED SCREENING AND HEALTH FAIRS.
FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 16JA SUMMARY OF THE FAP IS DISTRIBUTED IN UNEMPLOYMENT OFFICES AND OTHER AREAS IN THE COMMUNITY THAT TARGET THE ELIGIBLE POPULATION. A SUMMARY IS ALSO AVAILABLE AT LOCAL PHYSICIAN OFFICES, ADMISSIONS OFFICES, AND SENT WITH BILLING INVOICES. ALSO, UPON DISCHARGE, A PATIENT FINANCIAL REPRESENTATIVE MEETS WITH PATIENTS TO DISCUSS THEIR ABILITY TO PAY FOR SERVICES. INCLUDED AS PART OF THIS DISCUSSION IS A SUMMARY OF THE FAP. A PLAIN LANGUAGE SUMMARY OF THE FAP WAS ALSO WIDELY AVAILABLE ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://GSHCS.NET/PUB/GSHCS-CHARITY-CARE-POLICY.PDF FINANCIAL ASSISTANCE INFORMATION CAN BE FOUND WIDELY AVAILABLE ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://WWW.GSHEALTH.ORG/PAYING-FOR-YOUR-CARE
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
GOOD SHEPHERD MEDICAL GROUP
610 NW 11TH STREETHERMISTONOR97838CLINIC
VANGE JOHN MEMORIAL HOSPICE
610 NW 11TH STREETHERMISTONOR97838HOSPICE
TLC HOME HEALTH
610 NW 11TH STREETHERMISTONOR97838HOME HEALTH

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYTHE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2 INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCEMANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO CHARITY PATIENTS IS BASED ON AN OVERALL CHARITY CARE PERCENTAGE OF GROSS REVENUE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTSTHE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE FY2018 AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 3, ON PAGE 14, OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 7, ON PAGE 17 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8 - MEDICARE EXPLANATIONANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES & REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. GSHCS PROVIDES SERVICES TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THEY WILL NOT RECOVER ALL THE COSTS ASSOCIATED WITH PROVIDING THESE SERVICES. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATIONTHE ORGANIZATIONS COLLECTION PROCEDURES REQUIRES A FINANCIAL ADVISOR TO WORK WITH ANY PATIENT WHO IS IDENTIFIED AS POTENTIALLY BEING ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO SENDING THE ACCOUNT TO COLLECTION. IF DURING THE COURSE OF THE COLLECTION PROCESS THE COLLECTION AGENCY DETERMINES AN ACCOUNT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, IT IS REFERRED BACK TO THE HOSPITAL FOR FURTHER DISCUSSION WITH THE PATIENT OR FOR WRITE OFF. ALL FURTHER COLLECTION ACTION IS CEASED.
PART VI, LINE 2 - NEEDS ASSESSMENTGOOD SHEPHERD HEALTH CARE SYSTEM HAS PARTNERED WITH ST. ANTHONY HOSPITAL, UMATILLA AND MORROW COUNTY HEALTH DEPARTMENTS, AND OREGON CHILD DEVELOPMENT COALITION, AND CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO CONDUCT A UMATILLA AND MORROW COUNTIES COMMUNITY HEALTH NEEDS ASSESSMENT. OUR COMMUNITY HEALTHCARE NEEDS ASSESSMENT PROCESS HAS FIVE COMPONENTS THAT ARE CONDUCTED EVERY THIRD YEAR: 1. THE ONGOING COLLECTION AND EVALUATION OF COMMUNITY FEEDBACK FROM PATIENT SURVEYS AND COMMENT FORMS. 2. PATIENT AND COMMUNITY-MEMBER HEALTHCARE NEEDS FOCUS GROUPS. 3. A HEALTHCARE NEEDS SURVEY COMPLETED BY EMPLOYERS AND OTHER COMMUNITY LEADERS. 4. A FORMAL TELEPHONE SURVEY. 5. A DEMOGRAPHIC STUDY CONDUCTED BY THE OREGON OFFICE OF RURAL HEALTH. HARD COPIES OF THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT ARE AVAILABLE UPON REQUEST WITHOUT CHARGE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://WWW.GSHEALTH.ORG/HEALTH-ASSESSMENT-REPORT/ HARD COPIES OF THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST WITHOUT CHARGE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://WWW.GSHEALTH.ORG/WP- CONTENT/UPLOADS/UMATILLA_COUNTY_HEALTH_IMPROVEMENT_PLAN_2016-2019.PDF
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEOUR FINANCIAL COUNSELORS INFORM AND EDUCATE THE PEOPLE WE SERVE WITH RESPECT TO CHARITY CARE AND GOVERNMENTAL ASSISTANCE PROGRAMS. ALL PATIENTS AND RESPONSIBLE PARTIES, WHERE POSSIBLE, ARE APPRISED OF THE AVAILABILITY OF FINANCIAL COUNSELING SERVICES AT THE TIME AND POINT OF SERVICE. WE HAVE ARRANGED OUR PATIENT FLOW TO MAXIMIZE THE CONVENIENCE OF VISITING OUR FINANCIAL COUNSELORS AS PART OF THE GOOD SHEPHERD TREATMENT REGIME. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS PROVIDED IN WRITING TO THE PATIENTS UPON REQUEST, AND WHEN THE HOSPITAL IS ABLE TO IDENTIFY A POTENTIAL FAP-ELIGIBLE INDIVIDUAL UPON ADMISSIONS.
PART VI, LINE 4 - COMMUNITY INFORMATIONGOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) IS THE CORPORATE NAME FOR AN ORGANIZATION MADE UP OF SEVERAL ENTITIES, INCLUDING GOOD SHEPHERD MEDICAL CENTER, VANGE JOHN MEMORIAL HOSPICE, TLC HOME HEALTH, GOOD SHEPHERD MEDICAL GROUP, AND GOOD SHEPHERD CLINIC PHARMACY. GOOD SHEPHERD SERVES A CORE POPULATION OF ALMOST 50,000 PEOPLE IN THE CITY OF HERMISTON, OREGON AND IN 14 OUTLYING SMALLER TOWNS WITHIN A ROUGH 50-MILE RADIUS. THIS POPULATION IS LARGELY RURAL, WITH AGRICULTURE DOMINATING INDUSTRIAL ENTERPRISES. THE AVERAGE HOUSEHOLD INCOME IN HERMISTON IS 35,865. 17.1% OF RESIDENTS HAVE INCOMES BELOW FEDERAL POVERTY GUIDELINES. 31.3% OF RESIDENTS IDENTIFY AS NON-WHITE HISPANIC ETHNICITY, WITH A SIZABLE NUMBER OF SPANISH-PRIMARY SPEAKERS.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHGOOD SHEPHERD MAINTAINS OPEN, ACTIVE, AFFILIATE, AND COURTESY MEDICAL STAFFS, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED AND INTERESTED PHYSICIANS IN THE COMMUNITIES WE SERVE. GSHCS IS GOVERNED BY A TWELVE- MEMBER BOARD OF TRUSTEES. THE BOARD IS COMPRISED OF INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WITH AN EMPHASIS ON MAINTAINING A TRUE CROSS-SECTION OF CORE POPULATION COMMUNITIES WITHIN ITS MEMBERSHIP. OUR SURPLUS FUNDS ARE USED TO FUND COMMUNITY HEALTH EDUCATION CLASSES, AS WELL AS FUNDING BUILDING AND EQUIPMENT UPGRADES TO MAINTAIN THE HIGHEST QUALITY HEALTHCARE FOR OUR COMMUNITY. SURPLUS FUNDS ARE ALSO APPLIED TO ONGOING PROFESSIONAL EDUCATION AMONG OUR CLINICAL STAFF TO REMAIN CURRENT IN THE BEST PRACTICES OF MODERN HEALTHCARE. WE OPERATE A FULLY-STAFFED 24-HOUR EMERGENCY ROOM, AVAILABLE TO THE PUBLIC REGARDLESS OF ABILITY TO PAY. WE LIVE OUR MISSION TO PROMOTE A HEALTHY COMMUNITY. GOOD SHEPHERD IS THE HOST AND DRIVING FORCE BEHIND THE GOOD SHEPHERD WELLNESS COALITION, A GRASS-ROOTS GROUP OF COMMUNITY LEADERS THAT IDENTIFY, ANALYZE, AND ADDRESS PRESSING HEALTHCARE ISSUES IN THE COMMUNITY. WE MAINTAIN A DIALOGUE WITH THE PEOPLE WE SERVE THROUGH A BIWEEKLY RADIO SHOW, WITH AN EMPHASIS ON WELLNESS AND PREVENTATIVE CARE. GOOD SHEPHERD HOSTS AN ANNUAL FAMILY HEALTH AND FITNESS DAY, WITH FREE ACCESS TO HEALTHCARE PROFESSIONALS, FREE SCREENINGS, AND A WEALTH OF HEALTH AND WELLNESS INFORMATION AVAILABLE TO THE PUBLIC. WE ARE ACTIVE IN COMMUNITY HEALTH-RELATED ACTIVITIES, INCLUDING THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, THE MARCH OF DIMES' MARCH FOR BABIES, AND THE UMATILLA COUNTY FAIR, WHERE WE PROVIDE HEALTH INFORMATION AND HEALTHCARE-RELATED GIVEAWAYS.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORTOREGON

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescBusiness Name Line2RecipientBusinessName/BusinessNameLine2Txt
GOOD SHEPHERD COMMUNITY HEALTH FDN
610 NW 11TH STREETHERMISTONOR97838931170546501C3$389,000FINANCIAL SUPPORT
BLUE MOUNTAIN COMMUNITY COLLEGE
975 SE COLUMBIA DRIVEHERMISTONOR97838930506536GOV$40,000FINANCIAL SUPPORT
UMATILLA COUNTY FIRE DISTRICT
320 S 1ST STREETHERMISTONOR97838812661780GOV$23,422EMS TRAINING$10,797COSTSTAT EQUIPMENT
CITY OF HERMISTON
180 NE 2ND STREETHERMISTONOR97838936002182GOV$450,000TRAFFIC SIGNALS
OREGON GRADUATE MEDICAL EDUCATION
1327 SE TACOMA STREET 341PORTLANDOR97202814027478501C3$25,000RURAL TRAINING PROGRCONSORTIUM
HERMISTON SCHOOL DISTRICT
305 SW 11TH STREETHERMISTONOR97838936002733GOV$37,800ATHLETIC TRAINER
FieldValueIRS element (for citing)
Total501c3 Org6Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Cash Grant$41,282CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationREQUESTS FOR FINANCIAL ASSISTANCE ARE APPROVED BY THE BOARD PRIOR TO DISBURSEMENT. ANY ORGANIZATION RECEIVING AN AWARD MUST SIGN AN AGREEMENT BEFORE THE FUNDS ARE DISPURSED STATING THE FUNDS WILL BE USED FOR THE STATED PURPOSE AS LISTED IN THEIR GRANT APPLICATION. GRANTS AWARDED TO GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION, A RELATED ORGANIZATION WHICH IS TAX EXEMPT UNDER SECTION 501(C)(3), ARE REQUIRED TO SUBMIT REGULAR REPORTS UNTIL ALL FUNDS HAVE BEEN SPENT. THESE REPORTS ARE REVIEWED AT THE FOUNDATION MEETINGS OF WHICH BOARD MEMBERS WHO SERVE ON BOTH THE HOSPITAL AND THE FOUNDATION BOARDS ATTEND. THERE ARE NO REPORTING REQUIREMENTS REQUIRED TO BE SENT TO THE HOSPITAL FROM THE OTHER ORGANIZATIONS LISTED ON SCHEDULE I.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
DENNIS BURKE
PRESIDENT/CEO$332,287$45,000$69,780$28,523$21,458$497,048
JAN PETER
CFO$210,019$20,912$9,625$16,970$26,960$284,486
JIM SCHLENKER
COO$198,203$19,385$9,842$5,788$24,228$257,446
JEREMY ANDERSON
ORTHO$574,418$8,901$14,334$597,653
THOMAS HOLT
UROLOGIST$340,000$7,000$18,550$13,443$378,993
CHRISTOPHER KEELER
SURGEON$316,349$3,000$15,900$3,527$338,776
LEONIDEZ DE GUZMAN
HOSPITALIST$289,952$28,689$16,070$13,334$348,045
LEILA KEELER
OB/GYN$304,225$5,000$15,900$29,489$354,614

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PAGE 1, PART I, LINE 7FormAndLineReferenceDesc
ExplanationAT THE END OF THE FISCAL YEAR THE BOARD DETERMINES THE AMOUNT OF FUNDS THAT WILL BE DISBURSED FOR BONUSES BASED ON THE ACHEIVEMENT OF SPECIFIED GOALS. MANAGEMENT THEN DETERMINES THE PERCENTAGE OF BONUSES ALLOCATED TO EACH LEVEL AND EACH INDIVIDUAL. THE HOSPITAL MAY ALSO PAY THE CEO A DISCRETIONARY ANNUAL BONUS IN AN AMOUNT TO BE DETERMINED BY THE BOARD OR COMMITTEE BASED UPON THE CEO'S ANNUAL REVIEW.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonNANCY MABRYPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionBOARD MEMBERRelationshipDescriptionTxt
Transaction$565,960TransactionAmt
TransactionCOLLECTIONS CO OWNERTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationCREDITS INC. IS A COLLECTION SERVICE AGENCY USED BY GSHCS WHICH IS OWNED 100% BY A BOARD MEMBER.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4AUNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS DURING THE YEAR WAS 45,047,106. THE UNREIMBURSED AMOUNTS ARE VALUED AT CHARGES FOREGONE. OUR EMERGENCY CENTER IS OPEN AROUND-THE-CLOCK TO ALL COMMUNITY MEMBERS, VISITORS, AND TRAVELERS, WITHOUT REGARD TO ONE'S ABILITY TO PAY.
FORM 990, PART VITHE FOLLOWING BOARD MEMBERS OF GSHCS ARE ALSO BOARD MEMBERS OF GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION, A RELATED ORGANIZATION: TOM WAMSLEY, BILL ELFERING, AND JANET COOLEY
FORM 990, PAGE 6, PART VI, LINE 2SEE ABOVE BUSINESS RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 11BA COPY OF THE 990 IS PROVIDED TO THE CFO AND CONTROLLER WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12CALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES WITH CONFLICTS ARE EXPECTED TO DISCLOSE CONFLICTS OF INTEREST ON A VOLUNTARY BASIS AND REFRAIN FROM DISCUSSION AND/OR VOTING ON RELATED MATTERS AS NECESSARY. THESE DISCLOSURES ARE REVIEWED AND DETERMINED TO EXIST OR NOT TO EXIST BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15ATHE CEOS COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS BASED ON SURVEY INFORMATION. THIS PROCESS IS COMPLETED ANNUALLY IN THE MONTH OF OCTOBER. THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED BY THE CEO BASED ON SURVEY INFORMATION. THIS PROCESS IS COMPLETED ANNUALLY ON THE ANNIVERSARY DATE OF THE INDIVIDUALS HIRE DATE.
FORM 990, PAGE 6, PART VI, LINE 15BSEE FORM 990, PART VI, LINE 15A ABOVE.
FORM 990, PAGE 6, PART VI, LINE 19THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G12,965,656 1,998,449 10,262
FORM 990, PART XI, LINE 9LOSS RESULTING FROM FIRE -1,773,083 CHANGE IN RESTRICTED NET ASSETS -239,960 TOTAL -2,013,043

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD COMMUNITY HEALTH FOUNBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11TH STREETAddressLine1Txt
CityHERMISTONCityNm
State AbbreviationORStateAbbreviationCd
ZIP97838ZIPCd
FieldValueIRS element (for citing)
EIN931170546EIN
Primary ActivitiesFUNDRAISINPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1GSHCSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (true)ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD MEDICAL SERVICES CORPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11TH STREETAddressLine1Txt
CityHERMISTONCityNm
State AbbreviationORStateAbbreviationCd
ZIP97838ZIPCd
FieldValueIRS element (for citing)
EIN900688940EIN
Primary ActivitiesPHARMACYPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
GOOD SHEPHERD MEDICAL SERVICE CORP
A$573,091GAAP ACCOUNTING
GOOD SHEPHERD COMMUNITY HEALTH FOUN
B$389,000GAAP ACCOUNTING
GOOD SHEPHERD COMMUNITY HEALTH FOUN
O$98,903ACTUAL