2018-05-14T12:03:09-05:00 2017-06-30 930623286 ALDRICH CPAS AND ADVISORS LLP 5665 SW MEADOWS RD SUITE 200 LAKE OSWEGO OR 97035 990 2016-07-01 930823471 SALEM HEALTH HOSPITALS & CLINICS SALE 5038141938 890 OAK STREET SALEM OR 97301 JAMES PARR CHIEF FINANCIAL OFFICER 5038141938 2018-05-07 1 JOYLYN M ANKENEY CPA P00366587 5036204489 2018-05-07 2016 2022-09-23 18:48:47Z JAMES PARR 890 OAK STREET SALEM OR 97301 1201798 0 X WWW.SALEMHEALTH.ORG X 1982 OR TO SUPPORT SALEM HEALTH, SALEM HEALTH WEST VALLEY AND RELATED FOUNDATIONS. 11 9 0 11 0 0 0 0 1726000 1201543 189 255 73580 0 1799769 1201798 0 0 0 0 0 0 0 0 0 0 0 0 0 1799769 1201798 3696512 4898310 545456 545456 3151056 4352854 TO SUPPORT SALEM HEALTH, SALEM HEALTH WEST VALLEY AND RELATED ORGANIZATIONS. 0 0 0 1100000 SALEM HEALTH HOSPITALS & CLINICS, THROUGH MEMBERSHIP IN WILLAMETTE VALLEY COMMUNITY HEALTH, SUPPORTS THE COORDINATED CARE OF THE COMMUNITY. 101543 LEASES LAND TO SALEM HEALTH 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X X SALEM HEALTH 5038141938 890 OAK STREET SE SALEM OR 97301 BONNIE DRIGGERS RN CHAIRPERSON 5.00 X X 0 0 0 KATHERINE KEENE L VICE CHAIR 4.25 X X 0 0 0 ALAN WYNN SECRETARY/TREASURER 5.25 X X 0 0 0 JOHN COMBES MD TRUSTEE 5.25 X 0 0 0 THERESA HASKINS TRUSTEE 3.50 X 0 0 0 ROB KELLY MD TRUSTEE 5.00 X 0 0 0 JOHN LATTIMER TRUSTEE 5.00 X 0 0 0 NANCY REYES-MOLYNEUX MD TRUSTEE 5.25 X 0 0 0 KENNETH SHERMAN JR TRUSTEE 7.00 X 0 0 0 LANE SHETTERLY TRUSTEE 7.00 X 0 0 0 ROBERT WELLS PAST CHAIRMAN 5.25 X 0 0 0 CHERYL NESTER WOLFE PRESIDENT & CEO 2.00 38.00 X 0 730298 72614 JAMES PARR CHIEF FINANCIAL OFFICER 1.00 39.00 X 0 439053 81331 0 1169351 153945 0 0 1 0 0 CCO MEMBERSHIP REVENUE 900099 1100000 1100000 SALEM HEALTH LAND LEAS 532000 101543 101543 1201543 255 255 1201798 1201543 0 255 0 0 0 0 126251 126506 917063 917063 917063 545456 545456 2107742 3309285 3696512 4898310 545456 545456 545456 545456 X 3151056 4352854 3151056 4352854 3696512 4898310 1201798 0 X 0 1 X 1 0 X X 3 SALEM HEALTH 930579722 3 1 0 0 SALEM HEALTH WEST VALLEY 431960221 3 0 0 0 SALEM HEALTH FOUNDATION 237002687 7 1 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 1 SALEM HEALTH HOSPITALS AND CLINICS IS ORGANIZED AND OPERATED TO CARRY OUT THE PURPOSES OF, AND PERFORM FUNCTIONS FOR SALEM HEALTH AND OTHER RELATED ENTITIES FURTHERING THE MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES SERVED. THESE ENTITIES INCLUDE SALEM HEALTH, SALEM HEALTH WEST VALLEY, SALEM HEALTH PROFESSIONAL SERVICES, SALEM HEALTH FOUNDATION, AND WEST VALLEY HOSPITAL FOUNDATION WHICH ARE ALL 501(C)(3) ENTITIES WHO'S SOLE CORPORATE MEMBER IS SALEM HEALTH HOSPITALS AND CLINICS. 917063 917063 917063 INVESTMENT IN WVCH 545456 C 545456 DUE FROM SALEM HEALTH 2759285 DUE FROM SALEM HEALTH WEST VALLEY 550000 3309285 DUE TO SALEM HEALTH 545456 545456 X 1201798 0 1201798 0 1201798 0 0 0 0 0 PART X, LINE 2: THE CORPORATION (SALEM HEALTH HOSPITALS & CLINICS), SALEM HEALTH, WEST VALLEY, SHF, WVHF, SHPS, AND WVIC ARE TAX-EXEMPT ORGANIZATIONS PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). AS SUCH, ONLY UNRELATED BUSINESS INCOME IS SUBJECT TO FEDERAL OR STATE INCOME TAXES. MANAGEMENT HAS NOT RECORDED A PROVISION AS UNRELATED BUSINESS INCOME, IF ANY, IS IMMATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2017 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CORPORATION MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO FISCAL YEAR 2011. 0 1 0 0 0 0 1 1 0 CHERYL NESTER WOLFE PRESIDENT & CEO 0 579665 0 143292 0 7341 0 57385 0 15229 0 802912 0 0 JAMES PARR CHIEF FINANCIAL OFFICER 0 398813 0 38833 0 1407 0 45500 0 35831 0 520384 0 0 PART I, LINE 4B SOME OF THE ORGANIZATION'S EMPLOYEES RECEIVE DEFERRED COMPENSATION UNDER A 457(F) NONQUALIFIED PLAN. THIS COMPENSATION IS INCLUDED IN COMPENSATION REPORTED IN PART II. THE TOTAL NONQUALIFIED PORTION OF EACH PERSONS DEFERRED COMPENSATION IS: CHERYL NESTER WOLFE $79,653 ($39,493 INCLUDED IN BONUS & INCENTIVE COMPENSATION AND $40,160 INCLUDED IN DEFERRED COMPENSATION) JAMES PARR $28,275 (INCLUDED IN DEFERRED COMPENSATION) PART I, LINE 6 FOR KEY EMPLOYEES AND MANAGEMENT OF SALEM HEALTH THE BOARD OF TRUSTEES HAS APPROVED AN ANNUAL LEADERSHIP INCENTIVE PROGRAM THAT PROVIDES FOR INCENTIVE PAYMENTS BASED ON OBJECTIVE CRITERIA RELATED TO QUALITY AND SAFETY, ENGAGEMENT, PATIENT SATISFACTION AND FINANCIAL PERFORMANCE. AMOUNTS NOTED ON SCHEDULE J PART II COLUMN (II) REFLECT PAYMENTS EARNED UNDER THE LEADERSHIP INCENTIVE PLAN. PART I, LINE 7 THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES, IN CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, REVIEWS CEO TOTAL COMPENSATION AND PERFORMANCE ANNUALLY. AS PART OF THE COMMITTEE'S ACTIONS, A NON-FIXED BONUS MAY BE AWARDED TO THE CEO. FORM 990, PART VI, SECTION A, LINE 4 ARTICLES WERE AMENDED, EFFECTIVE AS OF JULY 1, 2016, IN ORDER TO CHANGE ORGANIZATION'S NAME. UPDATED NAME WAS REFLECTED ON THE PRIOR YEAR FORM 990. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE 990. IT IS THEN FORWARDED TO THE ENTIRE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS THE SECRETARY OF THE HOSPITAL SHALL SEND TO EACH PERSON WHO IS A TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE, AND TO THOSE EMPLOYEES OF THE HOSPITAL AS THE BOARD MAY DETERMINE, A COPY OF THE POLICY REGARDING CONFLICTS OF INTEREST, TOGETHER WITH A QUESTIONNAIRE INQUIRING AS TO CONFLICTS, IS TO BE COMPLETED AND RETURNED TO THE SECRETARY BY THE TRUSTEE, OFFICER, COMMITTEE MEMBER OR EMPLOYEE PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION AT SALEM HEALTH (SH) IS DESIGNED TO ALLOW THE ORGANIZATION TO RECRUIT AND RETAIN QUALIFIED SENIOR LEADERS. THE GOVERNANCE COMMITTEE OF THE SH BOARD OF TRUSTEES, NONE OF WHOM IS AN SH EMPLOYEE, ENGAGES ONE OR MORE INDEPENDENT CONSULTANTS TO PROVIDE MARKET DATA ON EXECUTIVE COMPENSATION, INCLUDING BENEFITS, FOR THE CEO AND OTHER EXECUTIVES IN SIMILAR ROLES AT COMPARABLE ORGANIZATIONS. THIS INFORMATION IS USED BY THE GOVERNANCE COMMITTEE IN ITS DISCUSSIONS AND DECISIONS ON CEO COMPENSATION. THE CEO, IN CONJUNCTION WITH OTHER SALARY SURVEY OR PUBLIC INFORMATION AND THE INDEPENDENT CONSULTANT, ENSURES THAT EACH EXECUTIVE'S COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE ON THE HOSPITAL WEBSITE. SALEM HEALTH FOUNDATION 890 OAK STREET SE SALEM OR 97301 237002687 SUPPORTS SALEM HEALTH OR 501(C)(3) 7 N/A 0 SALEM HOSPITAL AUXILIARY 890 OAK STREET SE SALEM OR 97301 931081113 SUPPORTS SALEM HEALTH OR 501(C)(3) 9 N/A 0 SALEM HEALTH 890 OAK STREET SE SALEM OR 97301 930579722 HOSPITAL OR 501(C)(3) 3 SALEM HEALTH HOSPITALS AND CLINICS 1 SALEM HEALTH WEST VALLEY 525 SOUTHEAST WASHINGTON STREET DALLAS OR 97338 431960221 HOSPITAL OR 501(C)(3) 3 SALEM HEALTH HOSPITALS AND CLINICS 1 WEST VALLEY HOSPITAL FOUNDATION 525 SOUTHEAST WASHINGTON STREET DALLAS OR 97338 931298564 SUPPORTS SALEM HEALTH WEST VALLEY OR 501(C)(3) 11 TYPE 1 N/A 0 WILLAMETTE VALLEY INSURANCE COMPANY 745 FORT STREET HONOLULU HI 96813 201836190 CAPTIVE INSURANCE HI 501(C)(3) 11 TYPE 1 SALEM HEALTH HOSPITALS AND CLINICS 1 SALEM HEALTH PROFESSIONAL SERVICES 890 OAK STREET SE SALEM OR 97301 753175249 BILLING SERVICE FOR PROFESSIONAL FEES OR 501(C)(3) 3 SALEM HEALTH HOSPITALS AND CLINICS 1 OREGON COMMUNITY IMAGING LLC 2925 RYAN DR SE SALEM OR 97301 262683062 MEDICAL IMAGING COOPERATIVE OR SALEM HEALTH HOSPITALS AND CLINICS RELATED -2888 -93 0 1 0.33330 OHSU PARTNERS 3303 SW BOND AVE STE 6100 PORTLAND OR 97239 475584608 HEALTHCARE SYSTEM MANAGEMENT OR N/A RELATED 0 1 0.50000 POPULATION HEALTH ALLIANCE 601 SW 2ND AVE STE 1940 PORTLAND OR 97204 471546023 POPULATION HEALTH DATA MANAGEMENT OR N/A RELATED -2105000 1455000 0 0 0.21960 WILLAMETTE VALLEY COMMUNITY HEALTH 2995 RYAN DRIVE SE STE 200 SALEM OR 97301 455540852 COORDINATED CARE ORGANIZATION OR N/A RELATED 1100000 545000 0 0 0.18200 1 0 0 1 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 SALEM HEALTH A 101543 HISTORICAL LAND LEASE