2025-11-13T15:30:08-06:00 2024-12-31 990 2024-01-01 930951989 SAMARITAN HEALTH SERVICES SAMA 5417684857 CO SHS ACCOUNTING PO BOX 3000 CORVALLIS OR 973393000 DANIEL B SMITH SVP / CFO 5417684857 2025-10-28 1 2024 2025-03-06 01:10:19Z DOUGLAS BOYSEN 3600 NW SAMARITAN DR CORVALLIS OR 97330 329175896 0 X WWW.SAMHEALTH.ORG X 1986 OR TO ENHANCE COMMUNITY HEALTH THROUGH QUALITY SERVICES ACROSS A CONTINUUM OF CARE. 14 14 1583 15 1903499 5661 1062159 1276970 319342475 318270267 12565854 6529015 1989725 1684187 334960213 327760439 100400 8939 0 0 161835462 171784812 29946 26800 2417449 193971289 208336078 355937097 380156629 -20976884 -52396190 311756583 272371758 289257345 301889070 22499238 -29517312 X SAMARITAN HEALTH SERVICES (SHS) IS THE PARENT COMPANY OF A REGIONAL NETWORK OF TAX-EXEMPT HOSPITALS, PHYSICIANS, AND AFFILIATED ORGANIZATIONS. (CONTINUED ON SCHEDULE O)(CONTINUED FROM PART III) THE NETWORK, FORMED IN THE LATE 1990'S, SERVES APPROXIMATELY 290,000 RESIDENTS IN LINN, BENTON, LINCOLN AND PORTIONS OF POLK AND MARION COUNTIES IN OREGON. IT IS LOCALLY OWNED, AND ITS BOARDS OF DIRECTORS INCLUDE HOSPITAL LEADERS, PHYSICIANS AND COMMUNITY REPRESENTATIVES. SHS PROVIDES HEALTHCARE SERVICES REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, DISABILITY OR AGE. THE MISSION OF SHS IS "BUILDING HEALTHIER COMMUNITIES TOGETHER." THE COLLECTIVE VISION OF THE SHS SYSTEM IS TO SERVE OUR COMMUNITIES WITH PRIDE (PASSION, RESPECT, INTEGRITY, DEDICATION, AND EXCELLENCE). SHS SEEKS TO BE THE FIRST CHOICE OF CONSUMERS IN THE REGION AND TO LEAD COLLABORATIVE EFFORTS AMONG THOSE WHO SHARE SIMILAR GOALS. 0 0 325139197 316926081 AS THE PARENT ORGANIZATION, SHS PROVIDES ADMINISTRATIVE AND OTHER SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS, SUCH AS PATIENT BILLING, INFORMATION SERVICES, ACCOUNTING, AND EMPLOYEE RECRUITMENT. SHS SPONSORS A HEALTH PLAN THAT PROVIDES MEDICAL, DENTAL, AND PHARMACY BENEFITS TO EMPLOYEES OF SHS AND ITS AFFILIATES. AS A SYSTEM, SHS LOOKS CAREFULLY AT LOCAL HEALTH CARE NEEDS AND GIVES THOUGHTFUL CONSIDERATION TO THE MOST EFFECTIVE WAYS TO MEET THOSE NEEDS. THE RESULT IS A RICH MIX OF LOCAL AND CENTRALIZED REGIONAL SERVICES, WHICH PROVIDE HIGH VALUE AND EXCELLENT HEALTH CARE FOR PEOPLE AT ALL STAGES OF THEIR LIVES.SAMARITAN HEALTH SERVICES (SHS) HAS POLICIES THAT PROVIDE FOR SERVING THOSE WITHOUT THE ABILITY TO PAY FOR TREATMENT. THE POLICIES ESTABLISH CRITERIA BASED ON THE INCOME OF THE PERSON RESPONSIBLE FOR THE BILL AND COLLECTIONS ARE AT AMOUNTS LESS THAN ITS ESTABLISHED RATES ON A SLIDING SCALE DOWN TO NO PAYMENT AT ALL. IN 2024 SHS PROVIDED SERVICES THAT BENEFITED THE POOR AND OTHERS IN THE COMMUNITIES IT SERVED. IN ADDITION TO THE GRANTS SHOWN ON LINE 4B, SHS INCURRED $2,634,751 OF COMMUNITY BENEFIT COSTS, INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSION EDUCATION, AND COMMUNITY BUILDING ACTIVITIES 8939 8939 GRANTS PROVIDED BY SAMARITAN HEALTH SERVICES TO VARIOUS ORGANIZATIONS TO ASSIST RESIDENTS IN BENTON, LINN, LINCOLN COUNTIES. SEE SCHEDULE I FOR MORE DETAILS. 325148136 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 1 0 0 0 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 1736 0 1 1583 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X SAMARITAN HEALTH SERVICES 5417684857 PO BOX 3000 CORVALLIS OR 973393000 PAUL DASKALOS DO BOARD MEMBER / PHYSICIAN 1.00 39.00 X 0 53297 9603 NANCY SEIFERT BOARD CHAIR 1.00 2.00 X X 0 0 0 ROBERT ADAMS BOARD SECRETARY 1.00 2.00 X X 0 0 0 JUNE CHRISMAN BOARD TREASURER 1.00 1.00 X X 0 0 0 RANDY SPRINGER BOARD CHAIR ELECT 1.00 2.00 X X 0 0 0 JUDY LIST BOARD MEMBER 1.00 1.00 X 0 0 0 MILTON MORAN BOARD MEMBER 1.00 1.00 X 0 0 0 LOREN ROTH BOARD MEMBER 1.00 1.00 X 0 0 0 CHARLES MOURADIAN BOARD MEMBER 1.00 1.00 X 0 0 0 RICHARD KENYON BOARD MEMBER 1.00 2.00 X 0 0 0 TROY GARRETT MD BOARD MEMBER 1.00 X 0 0 0 STUART PRITCHARD BOARD MEMBER 1.00 1.00 X 0 0 0 RALPH BREITENSTEIN MD BOARD MEMBER 1.00 2.00 X 0 0 0 BRIAN CARROLL BOARD MEMBER 1.00 2.00 X 0 0 0 KELLY GALLAGHER BOARD MEMBER 1.00 2.00 X 0 0 0 ERIC THOMPSON BOARD MEMBER 1.00 1.00 X 0 0 0 DOUGLAS BOYSEN PRESIDENT & CEO 33.00 7.00 X 1336861 0 71010 DANIEL SMITH SVP / CFO 23.00 17.00 X 622805 0 66116 LAURA HENNUM VP CEO GSRMC (END AUG) 1.00 39.00 X 802185 0 45907 ROBERT TURNGREN MD SVP / CHIEF PHYSICIAN EXEC 39.00 1.00 X 647392 0 66045 JOSEPH CAHILL SVP / COO 1.00 39.00 X 628698 0 58457 WENDIE WUNDERWALD VP CEO MVH (END SEPT) 1.00 39.00 X 536648 0 52879 MARGARET MIKULA MD VP CHIEF QUAL OFFICER 40.00 X 506638 0 71975 BRUCE BUTLER VP CEO HEALTH PLANS 20.00 20.00 X 510080 0 43964 PANKAJ SAPRA SVP / CIO 40.00 X 461225 0 73414 LESLEY OGDEN MD VP CEO NLH / CEO SPCH 1.00 39.00 X 464515 0 60746 KELLEY KAISER SVP / CAO 35.00 5.00 X 448420 0 70133 DANIEL KETERI VP CEO SAGH 1.00 39.00 X 427713 0 66520 TYLER JACOBSEN VP CHIEF LEGAL OFFICER 40.00 X 377517 0 75766 JULIE OSGOOD VP COO SMG 40.00 X 381463 0 41820 DANIEL RACKHAM VP CEO MVH (START AUG) 40.00 X 297542 0 68730 JANET MCGUIRE VP REVENUE CYCLE 40.00 X 297034 0 43451 SCOTT RUSSELL VP HUMAN RESOURCES 40.00 X 267147 0 63672 SHILOH ERVEN VP SMG ADMINISTRATION 40.00 X 240734 0 60185 NANCY FRY VP FINANCE 40.00 X 224626 0 32482 WILLIAM BARISH MD CHIEF WELLNESS OFFICER 40.00 X 427992 0 63617 ANDREA MCCANN MD SENIOR MEDICAL DIRECTOR 40.00 X 415062 0 69777 BRENT GODEK MD VP CHIEF MEDICAL OFFICER SHPO 40.00 X 401287 0 55600 JEFFREY ABSALON MD SENIOR MEDICAL DIRECTOR 40.00 X 424078 0 14064 KRISTY JESSOP MD SENIOR MEDICAL DIRECTOR 39.00 1.00 X 369535 0 56807 11517197 53297 1402740 376 0 1 0 MEDEFIS INC PO BOX 5068 NEW YORK NY 100875068 STAFFING SERVICES 31677138 OREGON ONCOLOGY SPECIALISTS LLP 875 OAK ST STE 4030 SALEM OR 97301 STAFFING SERVICES 7550707 COMPHEALTH PO BOX 972625 DALLAS TX 753972625 STAFFING SERVICES 6429425 GORES CONSTRUCTION INC 5831 SE INTERNATIONAL WAY MILWAUKIE OR 97228 CONSTRUCTION SERVICES 4579377 GERDING BUILDERS LLC PO BOX 1082 CORVALLIS OR 97339 CONSTRUCTION SERVICES 3969260 293 180001 186170 910799 1276970 SUPPORT SERVICE FEES 561000 208871020 208871020 EMPL HEALTH PLAN PREM 525100 120949943 120949943 FITNESS CENTER REVENUE 713940 2024351 680165 1344186 OTH PROG SVC REVENUE 900099 596589 596589 RELEASE OF INFORMATION 900099 181279 181279 -14352915 -14352915 318270267 6425220 6425220 2623713 1390839 1232874 1232874 108000 1124874 128413 24618 103795 103795 103795 ADMIN & SUPPORT SVCS. 561000 427079 427079 JOINT VENTURES 900099 24234 24234 451313 327760439 316926081 1903499 7653889 8939 8939 10612514 10612514 115337822 90062104 23720742 1554976 6549006 5234794 1233361 80851 29834952 23847869 5618754 368329 9450518 7554050 1779796 116672 742784 729175 13609 736640 736640 99794 99794 26800 26800 57142 28571 28571 13623055 9832567 3755688 34800 805162 783814 19751 1597 14183128 13896711 255879 30538 15493934 15107867 386067 186992 132236 21664 33092 484997 316623 165490 2884 286711 251553 35145 13 883641 794058 89583 10312307 10055352 256955 3092620 2463857 628763 CLAIM FEES 115745455 115745455 PURCHASED SERVICES 30051523 28151489 1764990 135044 DUES, TAXES, & LICENSES 1342370 594532 738530 9308 MEDICAL SUPPLIES 129481 129481 78342 56420 12986 8936 380156629 325148136 52591044 2417449 800 800 159266302 101781129 2451619 1725498 18888 25100000 11397020 11093289 254893990 164291928 95849748 90602062 2424608 23011897 23042459 171551 171551 17164150 18854970 311756583 272371758 72185180 63675335 681836 468341 164391358 158557671 7594174 17786435 44404797 61401288 289257345 301889070 X 22499238 -29517312 22499238 -29517312 311756583 272371758 X -52396190 422425 -42785 X 0 1 X 1 1 1 X X 5 ALBANY GEN HOSP 930110095 3 1 0 30427777 GOOD SAM HOSP 930391573 3 1 0 66298047 MID-VALLEY HC 930396847 3 1 0 18152992 N LINCOLN HOSP 931305493 3 1 0 9355338 SAM PAC HLTH SVCS 931329784 3 1 0 15328874 5 0 139563028 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART I, LINE 12G AS THE PARENT ORGANIZATION, SHS PROVIDES ADMINISTRATIVE AND OTHER SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS, SUCH AS PATIENT BILLING, INFORMATION SERVICES, ACCOUNTING, AND EMPLOYEE RECRUITMENT. THE AMOUNTS SHOWN ON PART I, LINE G REPRESENT THE VALUE OF THESE SERVICES ALLOCATED TO THE SUPPORTED ORGANIZATIONS. PART IV, SECTION A, LINE 6 ORGANIZATION(S) WERE GIVEN GRANTS TO SUPPORT THEIR EXEMPT FUNCTIONS. SEE SCHEDULE I PART II FOR MORE DETAILS. PART IV, SECTION D, LINE 1 AS THE PARENT COMPANY AND SOLE CORPORATE MEMBER OF ALL SUPPORTED ORGANIZATIONS, SHS PROVIDES MONTHLY FINANCIAL STATEMENTS SHOWING THE AMOUNT OF SUPPORT PROVIDED TO EACH OF ITS SUPPORTED ORGANIZATIONS. THE EXECUTIVE LEADERSHIP OF ALL SUPPORTED ORGANIZATIONS IS PRESENT FOR THE FINAL REVIEW OF THE FORM 990 WITH THE SHS BOARD OF DIRECTORS. IN ADDITION, THIS SAME LEADERSHIP TEAM IS PRESENT AT BOARD MEETINGS WHERE CHANGES TO GOVERNING DOCUMENTS ARE PROPOSED AND APPROVED. PART IV, SECTION D, LINE 3 THE SHS BOARD IS COMPOSED OF MEMBERS FROM THE SUPPORTED ORGANIZATIONS. PART IV, SECTION E, LINE 3A THE PARENT CORPORATION (SHS) HAS SEVERAL RESERVED POWERS PER THE BYLAWS OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I OF SCHEDULE A. FOR EXAMPLE, THE ELECTION AND REMOVAL OF DIRECTORS MUST BE APPROVED BY THE PARENT CORPORATION (SHS). PART IV, SECTION E, LINE 3B THE PARENT CORPORATION (SHS) HAS SEVERAL RESERVED POWERS PER THE BYLAWS OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I OF SCHEDULE A. THESE INCLUDE THE APPROVAL OF INDEBTEDNESS, THE APPROVAL OF ACQUISITIONS AND MERGERS, SALES AND TRANSFERS OF ASSETS, APPROVAL OF CAPITAL BUDGETS, AND ANY CHANGES TO THE ORGANIZATIONAL DOCUMENTS, AMONG OTHERS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 45089 1 32705 0 1 22000 99794 0 PART II-B, LINE 1: LINE 1F: THE FILING ORGANIZATION MAINTAINS MEMBERSHIP IN THE AMERICAN HOSPITAL ASSOCIATION (AHA). DURING TAX YEAR 2024, THE FILING ORGANIZATION PAID MEMBERSHIP DUES OF $115,612 TO THE AHA. 39% OF AHA DUES WENT FOR LOBBYING PURPOSES. THUS, THE FILING ORGANIZATION MADE INDIRECT LOBBYING EXPENDITURES OF $45,089 THROUGH ITS MEMBERSHIP DUES. THE FILING ORGANIZATION PAID AN INDEPENDENT CONTRACTOR $22,000 TO PROVIDE COMMENTS ON PROPOSED RULES WITH KEY STATE AGENCIES. PAID STAFF HAD DIRECT CONTACT WITH GOVERNMENT OFFICIALS REGARDING THE FOLLOWING TOPICS: LEGISLATIVE ADVOCACY IN KEY POLICY AREAS SUCH AS; COMMUNITY BENEFITS, HOSPITAL STAFFING, HEALTH CARE FINANCE, PUBLIC HEALTH EMERGENCIES, AND OTHERS. 32,705 OF THE PAID STAFF'S SALARY AND BENEFITS WAS ALLOCATED TO THESE ACTIVITIES BASED ON THEIR TIME SPENT WITH GOVERNMENT OFFICIALS. 3665000 16234670 19899670 21984159 72048609 44322530 49710238 3306989 2654309 652680 127960063 113778225 14181838 9694500 3536864 6157636 90602062 23042459 C 23042459 DEFERRED FINANCING COSTS, NET 1363686 SHS LT ASSETS - D&O INS 151901 SHS LT ASSETS - 457 PLAN 15049053 INTEREST RECEIVABLE 1090040 OTHER RECEIVABLES 1200290 18854970 LIABILITY FOR UNPAID MEDICAL CLAIMS 12695245 TENANT DEPOSITS 150000 ACCRUED INTEREST 1133886 OTHER LIABILITIES 165208 SHS LT LIABILITIES - 457 PLAN 15049053 ACCOUNTS PAYABLE - AFFILIATES 32207896 61401288 X PART X, LINE 2: FOOTNOTE DISCLOSURE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE THE SHS' MANAGEMENT TO EVALUATE TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF SHS HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY SHS AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SHS IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. SHS' MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2021. X X X X X 1 ONE SOURCE STRATEGY PO BOX 2170 FAIRVIEW OR 97024 SPECIAL EVENTS 0 0 26800 0 26800 OR PART 1 LINES IV & VI THE GROSS RECEIPTS ($147,777) AND OTHER EXPENSES ($30,077) FOR THESE EVENTS ARE RECORDED ON PACIFIC COMMUNITIES HEALTH DISTRICT FOUNDATION'S, A RELATED ORGANIZATION, BOOKS. 1 COMMUNITY HELPING ADDICTS NEGOTIATE CHANGE EFFECTIVELY PO BOX 1256 ALBANY OR 97321 203295927 501(C)(3) 6939 0 FUNDING FOR PEER SUPPORT SPECIALIST TRAINING 1 PART I, LINE 2: AGENCIES IN THE COMMUNITY ARE INVITED TO SUBMIT GRANT PROPOSALS THROUGH AN APPLICATION PROCESS. A COMMITTEE REVIEWS THE APPLICATIONS TO DETERMINE IF THE FUNDS REQUESTED WILL BE USED TO ADDRESS THE ORGANIZATION'S ESTABLISHED COMMUNITY HEALTH PRIORITIES, IDENTIFIED NEEDS, AND SUPPORTS THE ORGANIZATION'S MISSION. ONCE APPROVED AND FUNDED, AGENCIES MUST SUBMIT A COMPLETE ANNUAL REPORT DESCRIBING HOW THE FUNDS WERE USED, THE NUMBER OF CLIENTS SERVED, AND HOW OUTCOMES WERE ACHIEVED. X 1 1 X X X X X X 1 1 0 1 0 0 0 0 0 DOUGLAS BOYSEN PRESIDENT & CEO 1082734 0 199331 0 54796 0 27756 0 43254 0 1407871 0 0 0 LAURA HENNUM VP CEO GSRMC (END AUG) 290885 0 21914 0 489386 0 27756 0 18151 0 848092 0 0 0 ROBERT TURNGREN MD SVP / CHIEF PHYSICIAN EXEC 537651 0 28242 0 81499 0 27756 0 38289 0 713437 0 0 0 DANIEL SMITH SVP / CFO 539235 0 31558 0 52012 0 27756 0 38360 0 688921 0 0 0 JOSEPH CAHILL SVP / COO 513825 0 33171 0 81702 0 27756 0 30701 0 687155 0 0 0 WENDIE WUNDERWALD VP CEO MVH (END SEPT) 186173 0 9048 0 341427 0 27756 0 25123 0 589527 0 0 0 MARGARET MIKULA MD VP CHIEF QUAL OFFICER 456980 0 25989 0 23669 0 27756 0 44219 0 578613 0 0 0 BRUCE BUTLER VP CEO HEALTH PLANS 474648 0 21667 0 13765 0 27756 0 16208 0 554044 0 0 0 PANKAJ SAPRA SVP / CIO 433182 0 26233 0 1810 0 27756 0 45658 0 534639 0 0 0 LESLEY OGDEN MD VP CEO NLH / CEO SPCH 399478 0 25785 0 39252 0 27756 0 32990 0 525261 0 0 0 KELLEY KAISER SVP / CAO 398049 0 27052 0 23319 0 27756 0 42377 0 518553 0 0 0 DANIEL KETERI VP CEO SAGH 396788 0 24825 0 6100 0 20856 0 45664 0 494233 0 0 0 WILLIAM BARISH MD CHIEF WELLNESS OFFICER 427297 0 496 0 199 0 27756 0 35861 0 491609 0 0 0 ANDREA MCCANN MD SENIOR MEDICAL DIRECTOR 409824 0 3366 0 1872 0 27756 0 42021 0 484839 0 0 0 BRENT GODEK MD VP CHIEF MEDICAL OFFICER SHPO 366188 0 9849 0 25250 0 27756 0 27844 0 456887 0 0 0 TYLER JACOBSEN VP CHIEF LEGAL OFFICER 327047 0 19102 0 31368 0 27756 0 48010 0 453283 0 0 0 JEFFREY ABSALON MD SENIOR MEDICAL DIRECTOR 371653 0 50800 0 1625 0 0 0 14064 0 438142 0 0 0 KRISTY JESSOP MD SENIOR MEDICAL DIRECTOR 353061 0 8968 0 7506 0 27756 0 29051 0 426342 0 0 0 JULIE OSGOOD VP COO SMG 323763 0 22298 0 35402 0 22401 0 19419 0 423283 0 0 0 DANIEL RACKHAM VP CEO MVH (START AUG) 278430 0 7035 0 12077 0 23926 0 44804 0 366272 0 0 0 JANET MCGUIRE VP REVENUE CYCLE 285543 0 7277 0 4214 0 23069 0 20382 0 340485 0 0 0 SCOTT RUSSELL VP HUMAN RESOURCES 239679 0 11802 0 15666 0 20754 0 42918 0 330819 0 0 0 SHILOH ERVEN VP SMG ADMINISTRATION 216612 0 5610 0 18512 0 18056 0 42129 0 300919 0 0 0 NANCY FRY VP FINANCE 216178 0 4922 0 3526 0 15592 0 16890 0 257108 0 0 0 PART I, LINE 1A IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM/FITNESS FACILITY BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. EMPLOYEES CAN USE THEIR WELLNESS BENEFIT AT EITHER NON-SAMARITAN OR SAMARITAN (SAMFIT) GYM/FITNESS FACILITIES. IF AN EMPLOYEE PARTICIPATES AT A NON-SAMARITAN GYM, REIMBURSEMENT IS MADE FOR FEES. REIMBURSEMENT DOES NOT EXCEED $300 PER YEAR AND IS INCLUDED IN THEIR TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. ONE KEY EMPLOYEE USED THE NON-SAMARITAN GYM REIMBURSEMENT DURING THE FILING YEAR. IF EMPLOYEES USE THEIR WELLNESS BENEFIT AT A SAMARITAN (SAMFIT) GYM/FITNESS FACILITY, THEN THE ANNUAL COST OF EMPLOYEE MEMBERSHIP, $300, IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. ONE BOARD MEMBER, TWO OFFICERS, NINE KEY EMPLOYEES, AND ONE HIGHEST PAID EMPLOYEE, USED THE SAMARITAN (SAMFIT) GYM/FITNESS FACILITY BENEFIT DURING THE FILING YEAR. PART I, LINES 4A-B LINE 4A: LAURA HENNUM (A KEY EMPLOYEE) RECEIVED A SEVERANCE PAYMENT OF $476,597 DURING THE FILING YEAR DUE TO THE TERMINATION OF HER EMPLOYMENT CONTRACT. LINE 4B: THE FILING ORGANIZATION MAINTAINS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. HOWEVER, NO PERSONS LISTED IN PART VII OF FORM 990 ACCRUED DEFERRED COMPENSATION BENEFITS OR RECEIVED ANY PAYMENTS FROM THESE PLANS DURING THE FILING YEAR. PART I, LINE 5 VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION. A STATE OF OREGON - FACIL AUTHORITY 936001787 000000000 2009-09-30 15800000 CONST. OF MEDICAL SCHOOL 0 0 0 B STATE OF OREGON - FACIL AUTHORITY 936001787 000000000 2014-12-18 18952500 CONST OF MEDICAL OFFICE BLDG, HOSPITAL REMODELS 0 0 0 C STATE OF OREGON - FACIL AUTHORITY 936001787 68608JWF4 2016-11-16 89533143 HOSPITAL FACILITY CONSTRUCTION AND REMODELS 1 0 0 D STATE OF OREGON - FACIL AUTHORITY 936001787 68608JYJ4 2020-07-07 77108397 TO REFUND THE 2010 SERIES A BONDS 0 0 0 A 8879765 15865543 283537 15582006 2011 0 0 1 1 B 6137563 18989505 169620 18819885 2019 0 0 0 1 C 1155000 1030000 91172903 985093 62638694 27533538 15578 2020 1 0 0 1 D 3405000 77108397 1030309 76078088 2020 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 1 0 0 0 0 1 D 0 1 1 1 0 0.00100 0.00100 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 1 0 0 1 1 C 0 0 0 1 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: STATE OF OREGON - FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/14/2014 ISSUER NAME: STATE OF OREGON - FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/13/2020 ISSUER NAME: STATE OF OREGON - FACIL. AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/01/2021 PART II, LINE 3: DIFFERENCES ON THIS LINE AS COMPARED TO PART I(E) ARE DUE TO INVESTMENT EARNINGS AND UNREALIZED GAINS/LOSSES. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF THE SAMARITAN HEALTH SERVICES (SHS) AUDIT AND COMPLIANCE COMMITTEE PRIOR TO ITS FILING WITH THE IRS. SHS'S CHIEF FINANCIAL OFFICER CONDUCTED THE FORM 990 REVIEW WITH THE COMMITTEE AND PROVIDED TIME FOR QUESTIONS FROM THE GROUP. A FORMAL REPORT OF THIS COMMITTEE HAS BEEN MADE TO THE FULL BOARD OF DIRECTORS OF SHS. ADDITIONALLY, A COMPLETE COPY OF THE FILING ORGANIZATION'S FINALIZED FORM 990 AND RELATED SCHEDULES WAS PROVIDED ELECTRONICALLY TO ALL MEMBERS OF THE FILING ORGANIZATION'S GOVERNING BOARD PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBER CONFLICTS OF INTEREST: THE MEMBERS OF THE BOARD MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CORPORATE COMPLIANCE OFFICER. IF A CONFLICT IS DISCLOSED THAT COULD PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THIS IS EVALUATED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES (SHS) BOARD OF DIRECTORS TO DETERMINE WHETHER THE MEMBER SHOULD CONTINUE TO SERVE ON THE BOARD. IF A CONFLICT IS DISCLOSED THAT DOES NOT PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THE CONFLICT IS MANAGED THROUGH A PROCESS SET FORTH IN THE ORGANIZATION'S BYLAWS. THE BYLAWS PROHIBIT ANY BOARD MEMBER FROM VOTING ON AN ACTION WHERE AN INDIVIDUAL MEMBER HAS A CONFLICT OF INTEREST. EMPLOYEE CONFLICTS OF INTEREST: THE SHS CODE OF CONDUCT AND BUSINESS ETHICS REQUIRES THAT ALL SHS EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST. THROUGH THE HUMAN RESOURCES SOFTWARE, PERFORMANCE MANAGER, THE DISCLOSURE REQUIREMENT NOTICE IS ASSIGNED TO ALL EMPLOYEES AND BY YEAR END ALL TASKS ARE TO BE COMPLETED. IF THERE IS A PERCEIVED CONFLICT OF INTEREST IT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, LEGAL COUNSEL AND/OR SENIOR MANAGEMENT. ACTUAL CONFLICTS OF INTEREST ARE REVIEWED AND DISCUSSED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF SAMARITAN HEALTH SERVICES PERIODICALLY ENGAGES AN INDEPENDENT CONSULTANT TO ASSIST IT IN PROVIDING COMPARABLE MARKET DATA FOR THE CEO, WHO IS THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. THIS ANALYSIS INCLUDES REGIONAL AND NATIONAL DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THIS INFORMATION IS USED BY THE COMPENSATION COMMITTEE IN ITS DELIBERATIONS REGARDING THE CEO'S COMPENSATION WHICH IS DOCUMENTED IN THE COMMITTEE'S MINUTES. THE CEO OF THE ORGANIZATION RELIES ON PUBLICLY AVAILABLE INFORMATION TO DETERMINE THE COMPENSATION FOR OTHER TOP MANAGEMENT OFFICIALS WITHIN THE ORGANIZATION. HE CONSULTS WITH THE INDEPENDENT CONSULTANT AS TO THE REASONABLENESS OF THIS DATA TO ENSURE THAT EACH TOP MANAGEMENT OFFICIAL'S COMPENSATION IS REASONABLE AS COMPARED TO SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. PHYSICIAN EMPLOYEE COMPENSATION, INCLUDING PHYSICIANS WHO ARE BOARD MEMBERS, IS REVIEWED AT LEAST ANNUALLY BY SENIOR MANAGEMENT. THIS REVIEW INCLUDES COMPARISON WITH PUBLISHED PHYSICIAN COMPENSATION STUDIES. FOR ALL OTHER EMPLOYEES, THE ORGANIZATION PERFORMS AN ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. SYSTEM-WIDE SUMMARIZED DATA IS ALSO PROVIDED IN THE ANNUAL REPORT TO THE COMMUNITY. THIS REPORT IS MADE AVAILABLE IN KIOSKS AND HIGH-TRAFFIC AREAS OF HOSPITALS AND PHYSICIAN CLINICS, AS WELL AS COMMUNITY PLACES SUCH AS THE PUBLIC LIBRARY. IT IS ALSO DISTRIBUTED TO THE BOARDS OF DIRECTORS AND DIRECTLY MAILED TO DONORS AND NEW RESIDENTS IN THE COMMUNITY. ADDITIONALLY, THE REPORT IS MADE AVAILABLE AT EVENTS, COMMUNITY OUTREACH PROJECTS, AND SCREENINGS ATTENDED THROUGHOUT THE YEAR. GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: BOOK TO TAX DIFFERENCES - JOINT VENTURES -42,785. 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