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SALEM HEALTH: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SALEM HEALTH (EIN 93-0579722)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-14
IRS object ID
201841349349304434
Schema version
2016v3.0
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)
Return2018-05-14T12:00:31-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930623286PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ALDRICH CPAS AND ADVISORS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1680 HAWTHORNE AVE SE 140AddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930579722EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SALEM HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSALEBusinessNameControlTxt
Phone5038141938PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1890 OAK STREETAddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES PARRPersonNm
Person TitleCFOPersonTitleTxt
Phone5038141938PhoneNum
Signature2018-05-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOYLYN M ANKENEY CPAPreparerPersonNm
PTINP00366587PTIN
Phone5035857774PhoneNum
Preparation2018-05-07PreparationDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAMES PARRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1890 OAK STREETAddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$772,378,081GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SALEMHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH AND WELL BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee5102TotalEmployeeCnt
Total Volunteers514TotalVolunteersCnt
Total Gross UBI$2,927,275TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$182,086NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,078,718PYContributionsGrantsAmt
CY Contributions Grants$1,293,735CYContributionsGrantsAmt
PY Program Service Revenue$541,672,117PYProgramServiceRevenueAmt
CY Program Service Revenue$749,790,070CYProgramServiceRevenueAmt
PY Investment Income$27,090,113PYInvestmentIncomeAmt
CY Investment Income$9,717,236CYInvestmentIncomeAmt
PY Other Revenue$271,919PYOtherRevenueAmt
CY Other Revenue$3,395,065CYOtherRevenueAmt
PY Total Revenue$570,112,867PYTotalRevenueAmt
CY Total Revenue$764,196,106CYTotalRevenueAmt
PY Grants And Similar Paid$359,286PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$804,612CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$276,554,506PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$386,294,442CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$235,467,985PYOtherExpensesAmt
CY Other Expenses$316,577,436CYOtherExpensesAmt
PY Total Expenses$512,381,777PYTotalExpensesAmt
CY Total Expenses$703,676,490CYTotalExpensesAmt
PY Revenues Less Expenses$57,731,090PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$60,519,616CYRevenuesLessExpensesAmt
Total Assets BOY$1,128,037,416TotalAssetsBOYAmt
Total Assets EOY$1,211,931,939TotalAssetsEOYAmt
Total Liabilities BOY$416,109,738TotalLiabilitiesBOYAmt
Total Liabilities EOY$391,556,988TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$711,927,678NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$820,374,951NetAssetsOrFundBalancesEOYAmt
MissionTO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$126,863,753ExpenseAmt
Revenue$348,513,552RevenueAmt
DescSALEM HEALTH IS ONE OF THE LARGEST OF OREGON'S 59 ACUTE CARE HOSPITALS AND OPERATES THE BUSIEST EMERGENCY DEPARTMENT IN OREGON. THERE ARE 467 PRACTITIONERS, REPRESENTING 54 DIFFERENT SPECIALTIES. MORE THAN 514 VOLUNTEERS PROVIDE NON-MEDICAL SUPPORT FOR THE HOSPITAL.STATISTICS FOR THE 12 MONTH PERIOD ENDED 6/30/17: BIRTHS - 3,498, DIAGNOSTIC IMAGING PROCEDURES - 188,318, ED VISITS - 111,041, INPATIENT ADMISSIONS - 25,907, LABORATORY PROCEDURES - 1,369,633, SURGERIES - 13,378. THE PRIMARY SERVICE AREA IS MARION AND POLK COUNTIES WITH APPROXIMATELY 500,000 RESIDENTS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$473,154,181ExpenseAmt
Revenue$386,909,587RevenueAmt
DescSALEM HEALTH PROVIDES HEALTHCARE TO PEOPLE IN OUR COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. IN THE 12 MONTH PERIOD ENDED 6/30/17, THE COST OF SERVICES PROVIDED AS A COMMUNITY BENEFIT TOTALED $86.3 MILLION. THIS FIGURE CONSISTED OF $8.4 MILLION IN COSTS TO PROVIDE CHARITY CARE TO INDIVIDUALS WHO CANNOT AFFORD TO PAY; $39.1 MILLION IN UNDERPAYMENT BY MEDICAID AS THE AMOUNT PAID WAS LESS THAN THE COST TO PROVIDE THE SERVICES; AND $38.8 MILLION IN UNDERPAYMENT BY MEDICARE AS THE AMOUNT PAID WAS LESS THAN THE COST TO PROVIDE THE SERVICES. SALEM HEALTH DOES NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST CHARITY CARE PATIENTS WHO HAVE DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$33,253,399ExpenseAmt
Grant$804,612GrantAmt
Revenue$16,083,680RevenueAmt
DescSALEM HEALTH ACTIVELY PARTICIPATES IN COMMUNITY HEALTH IMPROVEMENT SERVICES. IN THE 12 MONTH PERIOD ENDED 6/30/17, SALEM HEALTH GAVE $11.9 MILLION FOR UNFUNDED OR UNDERFUNDED HEALTH SERVICES, INCLUDING IMPROVING ACCESS TO CARE THROUGH PHYSICIAN RECRUITING, COMMUNITY HEALTH EDUCATION AND PREVENTION PROGRAMS. THE HOSPITAL HAS AN ACTIVE SPEAKERS BUREAU PROVIDING FREE HEALTH LECTURES TO COMMUNITY GROUPS. HEALTH SCREENINGS, SUPPORT GROUPS AND EDUCATION CLASSES ARE OFFERED ON AN ON-GOING BASIS. IN FY 2017, SALEM HEALTH PROVIDED MORE THAN $1 MILLION IN CASH AND IN-KIND DONATIONS TO COMMUNITY HEALTH PROGRAMS SUCH AS MEDASSIST AND PROJECT ACCESS, PSYCHIATRIC CRISIS CENTER AND THE SALEM FREE CLINIC.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$633,271,333TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document364IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee5102EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SALEM HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5038141938PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1890 OAK STREET SEAddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BONNIE DRIGGERS RN
CHAIR5.00Yes (X)Yes (X)$0$0$0
KATHERINE L KEENE
VICE CHAIR4.25Yes (X)Yes (X)$0$0$0
ALAN WYNN
SECRETARY/TREASURER5.25Yes (X)Yes (X)$0$0$0
THERESA HASKINS
TRUSTEE3.50Yes (X)$0$0$0
KENNETH SHERMAN JR
TRUSTEE7.00Yes (X)$0$0$0
ROB KELLY MD
TRUSTEE5.00Yes (X)$0$0$0
LANE SHETTERLY
TRUSTEE7.00Yes (X)$0$0$0
ROBERT WELLS
PAST-CHAIR5.25Yes (X)$0$0$0
NANCY REYES-MOLYNEUX MD
TRUSTEE5.25Yes (X)$0$0$0
JOHN COMBES MD
TRUSTEE5.25Yes (X)$0$0$0
JOHN LATTIMER
TRUSTEE5.00Yes (X)$0$0$0
CHERYL NESTER WOLFE
PRESIDENT AND CEO30.00Yes (X)$730,298$0$72,61410.00
JAMES PARR
CHIEF FINANCIAL OFFICER32.00Yes (X)$439,053$0$81,3318.00
RALPH YATES
CMO SALEM HEALTH AND SHMG40.00$446,271$0$70,5720.00Yes (X)
LAURIE BARR
VP HUMAN RESOURCES30.00$383,267$0$75,75410.00Yes (X)
SARAH HORN
CHIEF NURSING OFFICER40.00$331,092$0$73,369Yes (X)
LEAH MITCHELL
CIO - EFF 9/4/1639.00$407,289$0$61,5861.00Yes (X)
LORI JAMES-NIELSEN TERM 31717
SEE SCHEDULE J10.00$376,301$0$80,66130.00Yes (X)
ANDREW FURMAN
VP MEDICAL AFFAIRS40.00$366,489$0$58,7180.00Yes (X)
BAHAA WANLY
CHIEF OPERATING OFFICER40.00$304,241$0$63,0570.00Yes (X)
DENISE HOOVER
VP SURGICAL SERVICES40.00$205,916$0$47,789Yes (X)
SHEA CORUM
VP IT OPERATIONS - EFF 10/16/1640.00$156,059$0$41,808Yes (X)
LEILANI SLAMA
VP COMMUNITY ENGAGEMENT20.00$151,389$0$41,62320.00Yes (X)
NORMAN GRUBER
SEE SCHEDULE J - TERM 7/3/160.00$2,254,133$0$468,57040.00Yes (X)
JUAN OYARZUN - EFF 21917
DIRECTOR OF CARDIOTHORACIC MEDICINE40.00$1,240,266$0$81,273Yes (X)
JASWINDER KAUR
ADULT HOSPITALIST PHYSICIAN40.00$525,447$0$53,298Yes (X)
NERVIN FANOUS
CARDIOTHORACIC SURGEON40.00$782,854$0$53,274Yes (X)
NICOLE VANDERHEYDEN MD
TRAUMA DIR/ ASSOC CMO SHMG40.00$752,460$0$89,729Yes (X)
JAMES SAPIENZA
FMR CAO OF SHWV0.00$286,100$0$17,02240.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,138,925TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$1,532,048TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K605IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
OHSU
PO BOX 3595PORTLANDOR97208CONTRACT LABOR$3,057,544
PEACEHEALTH LABORATORIES
PO BOX 77003SPRINGFIELDOR97475LABORATORY SERVICES$2,460,555
EPIC SYSTEMS CORP
PO BOX 88314MILWAUKEEWI532880314CONSULTING SERVICES$2,326,463
SALEM PULMONARY ASSOCIATES PC
801 MISSION ST SESALEMOR97302CONTRACT LABOR$1,643,056
OREGON ANETHESIOLOGY GROUP
707 SW WASHINGTON ST SUITE 700PORTLANDOR972053536CONTRACT LABOR$1,518,561
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K107CntrctRcvdGreaterThan100KCnt
Related Organizations$903,927RelatedOrganizationsAmt
All Other Contributions$389,808AllOtherContributionsAmt
Total Contributions$1,293,735TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE621110$726,998,852$726,998,852
OTHER HOSPITAL SERVICES900099$15,103,846$15,013,584$90,262
PHARMACY446110$6,152,630$4,694,113$1,458,517
REGIONAL LAB621500$1,512,285$159,518$1,352,767
NUTRITION SERVICES722210$22,457$22,457
FieldValueIRS element (for citing)
Total Program Service Revenue$749,790,070TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,719,764TotalRevenueColumnAmt
Exclusion$15,719,764ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$586,854RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,835,813RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$1,248,959RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,248,959TotalRevenueColumnAmt
Exclusion-$1,248,959ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$343,634OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$6,346,162OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$6,002,528OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,002,528TotalRevenueColumnAmt
Exclusion-$6,002,528ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescPASSTHROUGH INCOMEDesc
Business541900BusinessCd
Total Revenue Column$4,644,024TotalRevenueColumnAmt
Related Or Exempt Func Income$4,618,295RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$25,729UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$4,644,024OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$764,196,106TotalRevenueColumnAmt
Related Or Exempt Func Income$751,506,819RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,927,275UnrelatedBusinessRevenueAmt
Exclusion$8,468,277ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$662,342TotalAmt
Program Services$662,342ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$142,270TotalAmt
Program Services$142,270ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$5,215,656TotalAmt
Management And General$5,215,656ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$297,475,961TotalAmt
Program Services$270,260,113ProgramServicesAmt
Management And General$27,215,848ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$62,520,249TotalAmt
Program Services$56,278,307ProgramServicesAmt
Management And General$6,241,942ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$21,082,576TotalAmt
Program Services$18,850,078ProgramServicesAmt
Management And General$2,232,498ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$5,601,814TotalAmt
Program Services$672,477ProgramServicesAmt
Management And General$4,929,337ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,851,961TotalAmt
Program Services$108,323ProgramServicesAmt
Management And General$1,743,638ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$451,375TotalAmt
Program Services$412,411ProgramServicesAmt
Management And General$38,964ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$89,400TotalAmt
Management And General$89,400ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$26,742,895TotalAmt
Program Services$23,080,556ProgramServicesAmt
Management And General$3,662,339ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$157,746TotalAmt
Program Services$11,543ProgramServicesAmt
Management And General$146,203ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,751,117TotalAmt
Program Services$4,028,676ProgramServicesAmt
Management And General$2,722,441ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$10,464,451TotalAmt
Program Services$3,967,053ProgramServicesAmt
Management And General$6,497,398ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,278,084TotalAmt
Program Services$10,677,687ProgramServicesAmt
Management And General$2,600,397ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,096,712TotalAmt
Program Services$630,116ProgramServicesAmt
Management And General$466,596ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,240,158TotalAmt
Program Services$814,753ProgramServicesAmt
Management And General$425,405ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$11,351,523TotalAmt
Program Services$11,351,523ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$43,574,869TotalAmt
Program Services$43,574,869ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,244,066TotalAmt
Program Services$4,244,066ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PATIENT SUPPLIES$102,652,141$102,138,345$513,796
BAD DEBTS$36,727,074$36,727,074
PROVIDER TAX$34,966,256$34,966,256
OTHER PURCHASED SERVICE$10,192,133$8,493,337$1,698,796

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,143,661TotalAmt
Program Services$1,179,158ProgramServicesAmt
Management And General$3,964,503ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$703,676,490TotalAmt
Program Services$633,271,333ProgramServicesAmt
Management And General$70,405,157ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$612,061BOYAmt
EOY$477,445EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,822,703BOYAmt
EOY$5,008,688EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$76,207,991BOYAmt
EOY$86,887,594EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,412,894BOYAmt
EOY$545,456EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,493,822BOYAmt
EOY$6,386,043EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,277,236BOYAmt
EOY$7,051,916EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$923,453,263LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$449,075,768LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$475,097,628BOYAmt
EOY$474,377,495EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$515,710,038BOYAmt
EOY$589,144,876EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$16,176,021BOYAmt
EOY$18,742,130EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$27,227,022BOYAmt
EOY$23,310,296EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,128,037,416BOYAmt
EOY$1,211,931,939EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$88,404,120BOYAmt
EOY$79,929,240EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$27,940EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$296,414,854BOYAmt
EOY$284,804,178EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$295,192BOYAmt
EOY$231,968EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,995,572BOYAmt
EOY$26,563,662EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$416,109,738BOYAmt
EOY$391,556,988EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$708,582,568BOYAmt
EOY$817,795,213EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,345,110BOYAmt
EOY$2,579,738EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$711,927,678BOYAmt
EOY$820,374,951EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,128,037,416BOYAmt
EOY$1,211,931,939EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$60,519,616ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$43,498,493NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$4,429,164OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$135,334FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$135,334FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$703,541,156FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$703,676,490FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$121,166CurrentYearMinus3Amt
Current Year Minus2$173,324CurrentYearMinus2Amt
Current Year Minus1$97,242CurrentYearMinus1Amt
Current Year$135,334CurrentYearAmt
Total$527,066TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-AFormAndLineReferenceDesc
ExplanationSALEM HEALTH CONTRACTED WITH PUBLIC AFFAIRS COUNSEL TO KEEP THE HOSPITAL APPRISED OF BILLS IN THE STATE LEGISLATURE AND TO ENGAGE THE LEGISLATORS ON BEHALF OF THE HOSPITAL WHEN NECESSARY TO PROVIDE INFORMATION TO LEGISLATORS REGARDING THE IMPACT OF LEGISLATION ON THE HOSPITAL. ADDITIONALLY, THE HOSPITAL PAYS MEMBERSHIP DUES TO OAHHS AND AHA. A PORTION OF THE DUES TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING ACTIVITY IN RELATION TO STATE AND NATIONAL HEALTHCARE ISSUES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,345,110BeginningYearBalanceAmt
Contributions$378,374ContributionsAmt
Investment Earnings Or Losses-$201,146InvestmentEarningsOrLossesAmt
Other Expenditures$937,381OtherExpendituresAmt
End Year Balance$2,584,957EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,619,320BeginningYearBalanceAmt
Contributions$683,999ContributionsAmt
Investment Earnings Or Losses$655,272InvestmentEarningsOrLossesAmt
Other Expenditures$613,481OtherExpendituresAmt
End Year Balance$3,345,110EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,560,192BeginningYearBalanceAmt
Contributions$318,689ContributionsAmt
Investment Earnings Or Losses-$66,873InvestmentEarningsOrLossesAmt
Other Expenditures$192,688OtherExpendituresAmt
End Year Balance$2,619,320EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,073,328BeginningYearBalanceAmt
Contributions$674,913ContributionsAmt
Investment Earnings Or Losses$154,704InvestmentEarningsOrLossesAmt
Other Expenditures$342,753OtherExpendituresAmt
End Year Balance$2,560,192EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,120,674BeginningYearBalanceAmt
Contributions$160,956ContributionsAmt
Investment Earnings Or Losses$379,362InvestmentEarningsOrLossesAmt
Other Expenditures$587,664OtherExpendituresAmt
End Year Balance$2,073,328EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$11,668,774InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$23,124,460OtherCostOrOtherBasisAmt
Book Value$34,793,234BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$13,495,102InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$590,851,274OtherCostOrOtherBasisAmt
Depreciation$248,566,417DepreciationAmt
Book Value$355,779,959BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$965,187InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$274,347,490OtherCostOrOtherBasisAmt
Depreciation$200,509,351DepreciationAmt
Book Value$74,803,326BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,000,976OtherCostOrOtherBasisAmt
Book Value$9,000,976BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$474,377,495TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
FAIR VALUE INTEREST RATE SWAP AGREEMENT$12,873,617
ACCRUED POST RETIREMENT HEALTHCARE BENEFITS$4,716,526
ACCRUED MALPRACTICE INSURANCE$4,027,567
ESTIMATED LIABILITY TO MEDICARE$2,070,420
DUE TO SALEM HEALTH HOSPITALS & CLINICS$2,759,285
OTHER LONG-TERM LIABILITIES$116,247
FieldValueIRS element (for citing)
Total Liability$26,563,662TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$822,516,954TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$43,498,493NetUnrealizedGainsInvstAmt
Other Revenue$14,822,355OtherRevenueAmt
Revenue Not Reported$58,320,848RevenueNotReportedAmt
Revenue Subtotal$764,196,106RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$764,196,106TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$712,089,463TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$8,868,311OtherExpensesIncludedAmt
Expenses Not Reported$8,868,311ExpensesNotReportedAmt
Expenses Subtotal$703,221,152ExpensesSubtotalAmt
Other Expenses Not Included$455,338OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$455,338ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$703,676,490TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE HELD BY SALEM HEALTH FOUNDATION FOR SALEM HEALTH SUPPORT.
PART X, LINE 2:UNCERTAIN TAX POSITIONS FROM THE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ISSUED FOR SALEM HEALTH AND RELATED COMPANIES: THE CORPORATION (SALEM HEALTH HOSPITALS & CLINICS), SALEM HEALTH, 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. THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH FASB ASC 740-10, INCOME TAXES-IMPLEMENTATION GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES AND DISCLOSURE AMENDMENTS FOR NONPUBLIC ENTITIES. 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 30,2016 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.
PART XI, LINE 2D - OTHER ADJUSTMENTS:REVENUE NETTED WITH EXPENSES 3,444,590. EXPENSE NETTED WITH REVENUE 11,377,765.
PART XI, LINE 4B - OTHER ADJUSTMENTS:OTHER RELATED ORGANIZATION REVENUE NOT INCLUDED ON FINANCIAL STATEMENTS
PART XII, LINE 2D - OTHER ADJUSTMENTS:REVENUE NETTED WITH EXPENSES 3,444,591. EXPENSES NETTED WITH REVENUE 11,377,765. CUMULATIVE EFFECT OF ADOPTION OF FAIR VALUE OPTION -5,954,045.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN BENEFICIAL INTEREST IN FOUNDATION -765,371. CHANGE IN POSTRETIREMENT BENEFIT OBLIGATION 1,220,709.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served31560PersonsServedCnt
Total Community Benefit Expns$8,372,306TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,372,306NetCommunityBenefitExpnsAmt
Total Expense0.01260TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served153759PersonsServedCnt
Total Community Benefit Expns$168,081,378TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$129,011,833DirectOffsettingRevenueAmt
Net Community Benefit Expns$39,069,545NetCommunityBenefitExpnsAmt
Total Expense0.05860TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served185319PersonsServedCnt
Total Community Benefit Expns$176,453,684TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$129,011,833DirectOffsettingRevenueAmt
Net Community Benefit Expns$47,441,851NetCommunityBenefitExpnsAmt
Total Expense0.07120TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served123044PersonsServedCnt
Total Community Benefit Expns$2,733,332TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,865DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,673,467NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served509PersonsServedCnt
Total Community Benefit Expns$1,366,183TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,366,183NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,165,597TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,023,815DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,141,782NetCommunityBenefitExpnsAmt
Total Expense0.01820TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$234,061TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$234,061NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served23112PersonsServedCnt
Total Community Benefit Expns$1,021,494TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,021,494NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served146665PersonsServedCnt
Total Community Benefit Expns$33,520,667TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,083,680DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,436,987NetCommunityBenefitExpnsAmt
Total Expense0.02610TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served331984PersonsServedCnt
Total Community Benefit Expns$209,974,351TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$145,095,513DirectOffsettingRevenueAmt
Net Community Benefit Expns$64,878,838NetCommunityBenefitExpnsAmt
Total Expense0.09730TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$213,424TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$213,424NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,047TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,047NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,918TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,918NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,724,917TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,724,917NetCommunityBenefitExpnsAmt
Total Expense0.00410TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,969,306TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,969,306NetCommunityBenefitExpnsAmt
Total Expense0.00440TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$36,727,074BadDebtExpenseAmt
Bad Debt Expense Attributable$18,314,682BadDebtExpenseAttributableAmt
Reimbursed By Medicare$103,595,961ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$114,046,368CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$10,450,407MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SALEM HEALTHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1890 OAK STREET SEAddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd
FieldValueIRS element (for citing)
State License14-1428StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SALEM HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.SALEMHEALTH.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.SALEMHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICYFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICYFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICYFAPSummaryOnWebsiteURLTxt
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
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Other ActionsYes (X)PermitOtherActionsInd
Collection Activities0CollectionActivitiesInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SALEM HEALTHPART V, SECTION B, LINE 3J: A COMPREHENSIVE NEEDS ASSESSMENT WAS CONDUCTED IN TAX YEAR 2015. THE NEEDS ASSESSMENT DESCRIBES THE COMMUNITY SERVED BY THE HOSPITAL AND THE DEMOGRAPHICS OF THE COMMUNITY. THE MARION AND POLK COUNTY HEALTH CARE SYSTEM CAPACITY AND ACCESS ASSESSMENT CONTAINS HEALTH CARE FACILITY AND RESOURCE INFORMATION. THE CAPACITY AND ACCESS ASSESSMENT IS UPDATED ANNUALLY. THE LATEST CHNA AND HEALTH CARE SYSTEM CAPACITY AND ACCESS ASSESSMENTS ARE PUBLISHED TO THE SALEM HEALTH WEBSITE AT WWW.SALEMHEALTH.ORG. THE NATIONAL MODEL, MOBILIZATION FOR ACTION THROUGH PLANNING AND PARTNERSHIPS OR MAPP WAS USED AS THE FRAMEWORK FOR THE COMMUNITY HEALTH ASSESSMENT. THE FOUR ASSESSMENTS OF THE MAPP FRAMEWORK INCLUDE: COMMUNITY THEMES AND STRENGTHS, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, COMMUNITY HEALTH STATUS ASSESSMENT AND THE FORCES OF CHANGE ASSESSMENT.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT WAS CONDUCTED BY SURVEYING COMMUNITY PARTNERS WORKING IN SOCIAL, HEALTH, COMMUNITY, EDUCATIONAL AND CORRECTIONAL HEALTH SETTINGS AND THE COMMUNITY-AT-LARGE. THE SURVEYS USED IN BOTH MARION AND POLK COUNTIES CONSISTED OF THE SAME QUESTIONS AND USED THE 2011 MARION COUNTY SURVEY AS A TEMPLATE. PAPER AND ELECTRONIC SURVEYS WERE ALLOCATED BASED ON POPULATION DISTRIBUTION THROUGHOUT OUR COMMUNITIES. THE COMMUNITY HEALTH STATUS ASSESSMENT WAS CONDUCTED BY COMPILING DATA FROM NATIONAL SURVEILLANCE SYSTEMS LIKE THE BEHAVIOR RISK FACTOR SURVEILLANCE SURVEY AND OREGON HEALTHY TEENS AS WELL AS STATE AND LOCAL DATA FROM BIRTH AND DEATH CERTIFICATES. IN ADDITION, AS SERIES OF COMMUNITY CAFES WERE CONDUCTED ACROSS MARION AND POLK COUNTY TO IDENTIFY HEALTH PRIORITIES.SALEM HEALTH HOSTED COMMUNITY CAFES AND REPRESENTATIVES FROM MARION AND POLK COUNTY PUBLIC HEALTH, PRESENTED CHNA FINDINGS TO THE SALEM HEALTH COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF TRUSTEES IN NOVEMBER 2015. THE MARION AND POLK COUNTY HEALTH REPORTS WAS PUBLISHED IN DECEMBER 2015 AND CAN BE FOUND ON THE SALEM HEALTH WEBSITE. WWW.SALEMHEALTH.ORG. THE DOCUMENT INFORMED THE DEVELOPMENT OF THE COMMUNITY BENEFIT IMPLEMENTATION STRATEGY FOR REPORTING YEARS 2015 - 2017, ALSO AVAILABLE ON THE WEBSITE.THE IMPACT OF ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITIES PRIOR CHNAS CAN BE FOUND ON THE COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) ANNUALLY REPORT. THE CHIP IS COORDINATED BY THE MARION COUNTY PUBLIC HEALTH DEPARTMENT AND IS PUBLISHED ON THEIR WEBPAGE AT HTTP://WWW.CO.MARION.OR.US/HLT/CHIP/PAGES/DEFAULT.ASPX.
SALEM HEALTHPART V, SECTION B, LINE 5: THE NATIONAL MODEL, MOBILIZATION FOR ACTION THROUGH PLANNING AND PARTNERSHIPS OR MAPP AS THE FRAMEWORK FOR THE COMMUNITY HEALTH ASSESSMENT. THE FOUR ASSESSMENTS OF THE MAPP FRAMEWORK INCLUDE: COMMUNITY THEMES AND STRENGTHS, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, COMMUNITY HEALTH STATUS ASSESSMENT AND THE FORCES OF CHANGE ASSESSMENT.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT WAS CONDUCTED BY SURVEYING COMMUNITY PARTNERS WORKING IN SOCIAL, HEALTH, COMMUNITY, EDUCATIONAL AND CORRECTIONAL HEALTH SETTINGS AND THE COMMUNITY-AT-LARGE. THE SURVEYS USED IN BOTH MARION AND POLK COUNTIES CONSISTED OF THE SAME QUESTIONS AND USED THE 2011 MARION COUNTY SURVEY AS A TEMPLATE. PAPER AND ELECTRONIC SURVEYS WERE ALLOCATED BASED ON POPULATION DISTRIBUTION THROUGHOUT OUR COMMUNITIES. THE COMMUNITY HEALTH STATUS ASSESSMENT WAS CONDUCTED BY COMPILING DATA FROM NATIONAL SURVEILLANCE SYSTEMS LIKE THE BEHAVIOR RISK FACTOR SURVEILLANCE SURVEY AND OREGON HEALTHY TEENS AS WELL AS STATE AND LOCAL DATA FROM BIRTH AND DEATH CERTIFICATES. IN ADDITION, A SERIES OF COMMUNITY CAFES WERE CONDUCTED ACROSS MARION AND POLK COUNTY TO IDENTIFY HEALTH PRIORITIES.SALEM HEALTH HOSTED COMMUNITY CAFES AND REPRESENTATIVES FROM MARION AND POLK COUNTY PUBLIC HEALTH, PRESENTED CHNA FINDINGS TO THE SALEM HEALTH COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF TRUSTEES IN NOVEMBER 2015.
SALEM HEALTHPART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH SANTIAM HOSPITAL AND LEGACY HEALTH.
SALEM HEALTHPART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH COMMUNITY ACTION AGENCY, THE EARLY LEARNING HUB, INC, MARION COUNTY HEALTH DEPARTMENT, POLK COUNTY HEALTH DEPARTMENT, OREGON STATE UNIVERSITY, COOPERATIVE EXTENSION, UNITED WAY, WVP HEALTH AUTHORITY, AND WILLAMETTE VALLEY COMMUNITY HEALTH.
SALEM HEALTHPART V, SECTION B, LINE 7D: THE HOSPITAL MADE THE CHNA WIDELY AVAILABLE TO THE COMMUNITY. ALL PARTNERS DESCRIBED IN SECTION B, LINE 6B WERE PROVIDED WITH EXECUTIVE SUMMARY DOCUMENTS FOR DISTRIBUTION TO COMMUNITY MEMBERS FREE OF CHARGE. THE FULL ASSESSMENT ARE POSTED TO HOSPITAL AND COUNTY WEBSITES.
SALEM HEALTHPART V, SECTION B, LINE 2: THE HOSPITAL WAS NOT ACQUIRED OR PLACED INTO SERVICE AS A TAX-EXEMPT HOSPITAL IN THE CURRENT TAX YEAR OR THE IMMEDIATELY PRECEDING TAX YEAR 2016.
SALEM HEALTHPART V, SECTION B, LINE 11: PRIORITY AREAS ADDRESSED IN THE 2015 ASSESSMENT INCLUDE: EARLY PRENATAL CARE, DEPRESSION SCREENING, OBESITY AND TOBACCO USE.SALEM HEALTH IS AN ACTIVE MEMBER OF THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP AND HAS REPRESENTATION ON THE PRENATAL CARE TASK FORCE ADDRESSING EARLY PRENATAL CARE. BABIES BORN TO MOTHERS WHO DO NOT RECEIVE PRENATAL CARE ARE THREE TIMES MORE LIKELY TO HAVE A LOW BIRTH WEIGHT AND FIVE TIMES MORE LIKELY TO DIE THAN THOSE BORN TO MOTHERS WHO DO GET CARE. EARLY PRENATAL CARE (I.E. CARE IN THE FIRST TRIMESTER OF A PREGNANCY) ALLOWS WOMEN AND THEIR HEALTH CARE PROVIDERS TO IDENTIFY AND, WHEN POSSIBLE, TREAT OR CORRECT HEALTH PROBLEMS AND HEALTH-COMPROMISING BEHAVIORS THAT CAN BE PARTICULARLY DAMAGING DURING THE INITIAL STAGES OF FETAL DEVELOPMENT. INCREASING THE NUMBER OF WOMEN WHO RECEIVE PRENATAL CARE, AND WHO DO SO EARLY IN THEIR PREGNANCIES, CAN IMPROVE BIRTH OUTCOMES AND LOWER HEALTH CARE COSTS BY REDUCING THE LIKELIHOOD OF COMPLICATIONS DURING PREGNANCY AND CHILDBIRTH.THE HEALTHY PEOPLE 2020 NATIONAL HEALTH TARGET IS TO INCREASE THE PROPORTION OF PREGNANT WOMEN WHO RECEIVE PRENATAL CARE IN THE FIRST TRIMESTER TO 77.9%. MARION COUNTY RATES ARE 75.1% AND POLK COUNTY MEETS THE TARGET AT 79.7%. TEEN AND LATINO MOTHERS DO NOT SEEK OR HAVE ACCESS TO EARLY PRENATAL CARE AT THE SAME RATES AS OLDER MOTHERS AND THOSE THAT IDENTIFY AS NON-HISPANIC, WHITE. TO ADDRESS THIS HEALTH PRIORITY, SALEM HEALTH COLLABORATES WITH THE SALEM KEIZER SCHOOL DISTRICT'S PROGRAM AT CHEMEKETA FOR PREGNANT AND PARENTING TEENS TO PROVIDE TEACHERS ON CHILDBIRTH TOPICS AND ALSO PROVIDE PRIVATE TOURS FOR THE TEENS THROUGH THEIR INSTRUCTOR. WE ATTEND HEALTH FAIRS AT CHEMEKETA FOR THIS GROUP A COUPLE OF TIMES A YEAR AND INCLUDE CAR SEAT DEMO AND INFORMATION. THE HOSPITAL COORDINATING OUTREACH TO TEENS. WE PUT OUT THE BROCHURES FOR THE OREGON MOTHERSCARE PROGRAM IN COOPERATION WITH THE MARION CO. HEALTH DEPT. THE HOSPITAL PROMOTES OREGON MOTHERSCARE. THE BOOT CAMP FOR NEW DADS REACHES THE TEEN DADS. WE POST ALL THESE CLASSES ON THE EARLY LEARNING HUB WEBSITE AND ALL THE AGENCIES ARE USING THIS WEB CALENDAR TO HELP PROMOTE THE CLASSES IN THE COMMUNITY. ADULT OBESITY RATES IN BOTH MARION AND POLK COUNTIES REMAIN ABOVE STATE AND NATIONAL AVERAGES AND ABOVE THE HP2020 GOAL OF 30.5%. LATEST RATES IN MARION COUNTY ARE REPORTED AT 32.7% AND POLK COUNTY 31.4%. SALEM HEALTH CONTINUES TO FOCUS ON OBESITY PREVENTION EFFORTS THROUGH HEALTH OUTREACH AND EDUCATION, SUPPORT OF PARTNERING AGENCIES WITH A SHARED GOAL TO DECREASE ADULT OBESITY, MEDICAL PROVIDER BMI SCREENING AND COMMUNITY HEALTH EDUCATION CENTER PROGRAMMING FOCUSING ON HEALTH PROMOTION AND PREVENTION OF CHRONIC DISEASE. OBESITY IS A PRIORITY FOR THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (CHIP). THE MARION COUNTY PUBLIC HEALTH DEPARTMENT CONVENES COMMUNITY STAKEHOLDER TO ADDRESS OBESITY USING A LOGIC MODEL AND COLLECTIVE IMPACT FRAMEWORK. PARTNERS ADDRESSING OBESITY SUBMIT ANNUAL ACTIVITIES AND REPORT RESULTS. SALEM HEALTH, AND OTHER COMMUNITY PARTNER'S COLLECTIVE IMPACT WORK, IS PUBLISHED ANNUALLY ON THE MARION COUNTY PUBLIC HEALTH WEBPAGE, CHIP REPORT.PSYCHOLOGICAL DISTRESS CAN AFFECT ALL ASPECTS OF OUR LIVES. OCCASIONAL DOWN DAYS ARE NORMAL, BUT PERSISTENT MENTAL/EMOTIONAL HEALTH PROBLEMS SHOULD BE EVALUATED AND TREATED BY A QUALIFIED PROFESSIONAL. FOR THIS REASON, SALEM HEALTH PROVIDES DEPRESSION SCREENING IN INPATIENT AND EMERGENCY ROOM SETTINGS. PRIMARY CARE CLINICS CONDUCT THE PHQ 9 AND THE COMMUNITY HEALTH EDUCATION CENTER ADDED THE PHQ2 TO SCREENING TO COMMUNITY HEALTH SCREENING PROGRAMS. MARION COUNTY RESIDENTS ON AVERAGE EXPERIENCE 4.1 POOR MENTAL HEALTH DAYS PER MONTH AND POLK COUNTY RESIDENTS ON AVERAGE EXPERIENCE 4.4 POOR MENTAL HEALTH DAYS PER MONTH, BOTH COUNTIES HAVE HIGHER THAN THE US AVERAGE VALUE OF 3.7 DAYS .TOBACCO IS THE AGENT MOST RESPONSIBLE FOR AVOIDABLE ILLNESS AND DEATH IN AMERICA TODAY. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, TOBACCO USE BRINGS PREMATURE DEATH TO ALMOST HALF A MILLION AMERICANS EACH YEAR, AND IT CONTRIBUTES TO PROFOUND DISABILITY AND PAIN IN MANY OTHERS. THE WORLD HEALTH ORGANIZATION STATES THAT APPROXIMATELY ONE-THIRD OF ALL TOBACCO USERS IN THIS COUNTRY WILL DIE PREMATURELY BECAUSE OF THEIR DEPENDENCE ON TOBACCO. MARION AND POLK COUNTIES HAVE SEEN A SIGNIFICANT INCREASE IN TOBACCO USE FROM 2010 TO 2013. WITH A HIGH SMOKING PREVALENCE THERE IS ALSO A GREATER EXPOSURE TO SECONDHAND SMOKE FOR NON-SMOKERS, WHICH CAN CAUSE OR EXACERBATE A WIDE RANGE OF ADVERSE HEALTH EFFECTS SUCH AS CANCER, RESPIRATORY INFECTIONS, AND ASTHMA.THE HEALTHY PEOPLE 2020 NATIONAL HEALTH TARGET IS TO REDUCE THE PROPORTION OF ADULTS AGED 18 YEARS AND OLDER WHO SMOKE CIGARETTES TO 12.0%. LATEST POLK COUNTY DATA SHOWS A RATE OF 16.4% AND MARION COUNTY HAS 19% OF ITS RESIDENTS REPORTING TOBACCO USE. SALEM HEALTH IS A SMOKE FREE CAMPUS AND HAS WORK WITH CITY PLANNERS TO EXPAND SMOKE FREE ZONES TO NEIGHBORING SIDEWALKS AND CITY PARKS. THE HOSPITAL SCREENS 100% OF PATIENTS FOR TOBACCO USE AND PROVIDES ALL TOBACCO USERS WITH COMMUNITY CESSATION RESOURCE INFORMATION. THE AMERICAN LUNG ASSOCIATION, FREEDOM FROM SMOKING CURRICULUM IS OFFERED AT THE SALEM HEALTH COMMUNITY HEALTH EDUCATION CENTER AND THE HEALTH EDUCATION AND OUTREACH TEAM PROVIDES COMMUNITY BASED EDUCATION TO SCHOOLS RELATED TO TOBACCO PREVENTION.
SALEM HEALTHPART V, SECTION B, LINE 13B: SALEM HEALTH FINANCIAL MATRIX IS BASED ON INCOME AS A PERCENT OF FEDERAL POVERTY LEVEL.
SALEM HEALTHPART V, SECTION B, LINE 13H: CRITERIA CONSIDERED IN DETERMINING ELIGIBILITY INCLUDE, BUT ARE NOT LIMITED TO: 1. THE HOUSEHOLD'S GROSS INCOME. 2. HOUSEHOLD'S ASSETS OTHER THAN PRIMARY RESIDENCE -EQUITY IN A REAL ESTATE (OTHER THAN THE PATIENT/GUARANTOR'S PRIMARY RESIDENCE), SECURITIES OR OTHER ASSETS ARE CONSIDERED AVAILABLE TO PAY THE PATIENT'S MEDICAL EXPENSES AND SHOULD BE INCLUDED IN THE INCOME CALCULATION -THE INCOME FROM INCOME-PRODUCING REAL PROPERTY SHOULD BE USED IN THE CALCULATION RATHER THAN THE EQUITY. -INDIVIDUAL RETIREMENT ACCOUNTS (IRAS) OR OTHER RETIREMENT FUNDS WILL NOT BE INCLUDED IN HOUSEHOLD ASSETS; HOWEVER DISTRIBUTIONS FROM THOSE FUNDS WILL BE CONSIDERED INCOME. 3. FAMILY SIZE (PERSONS LEGALLY RESPONSIBLE FOR THE PATIENT BILL AND THEIR DEPENDENTS) 4. THE FAMILY'S MONTHLY OUT OF POCKET EXPENSES FOR MEDICAL SUPPLIES AND SERVICES. 5. ELIGIBILITY MAY BE CONTINGENT UPON PATIENT COOPERATION WITH THE APPLICATION PROCESS. *THE DEFINITION OF 'HOUSEHOLD'S GROSS INCOME' INCLUDES THE COMBINED GROSS MONTHLY INCOME OF ALL PERSONS LEGALLY RESPONSIBLE FOR PATIENT BILL OR BALANCE. HOUSEHOLD INCOMES UP TO 400% OF THE ANNUAL FEDERAL POVERTY GUIDELINES (FPG) WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE AS OUTLINED BELOW AND IN THE FPG FINANCIAL MATRIX: FINANCIAL MATRIX INCOME AS A PERCENTAGE OF FEDERAL POVERTY LEVEL PERCENTAGE DISCOUNT 0-300% 100% 301-400% 65% ALL OTHER UNINSURED SEE OTHER SELF-PAY DISCOUNT POLICY
SALEM HEALTHPART V, SECTION B, LINE 15E: SUPPORTING DOCUMENTATION MAY INCLUDE THE FOLLOWING: PATIENT MUST PROVIDE TWO OF THE FOLLOWING DOCUMENTS TO SUPPORT THE INCOME CLAIMS ON THE APPLICATION. -THREE MONTHS INCOME VERIFICATION IN THE FORM OF PAY STUBS, BANK DEPOSITS, ETC. -SOCIAL SECURITY DETERMINATION LETTERS. -THE PRIOR YEAR'S TAX RETURNS OR 4506T-EZ -A "BASIC NEEDS" LETTER THAT INDICATES HOW PERSONS WITH NO INCOME ARE MEETING THEIR DAY TO DAY BASIC LIVING NEEDS. BASIC NEEDS" LETTER MUST ONLY BE CONSIDERED A SECONDARY SUPPORTING DOCUMENT AFTER THE FINANCIAL COUNSELOR OR CLERK VALIDATES THE INFORMATION. AS OUTLINED IN SALEM HEALTH'S CONDITION OF ADMISSION, A CREDIT BUREAU REPORT OR A CHARITY SCORING VENDOR MAY BE REQUESTED TO VALIDATE INFORMATION PROVIDED ON THE FINANCIAL ASSISTANCE APPLICATION. SALEM HEALTH MAY ACCEPT INFORMATION PROVIDED ON AN OHP APPLICATION, OHP ELIGIBILITY, PROBATE ESTATES DETERMINATION, DOCUMENTATION OF HOMELESS STATUS, OR RELIABLE THIRD PARTY CREDIT INFORMATION AS A SUBSTITUTE FOR THE FINANCIAL FORMS. OHP INFORMATION WILL BE CONSIDERED VALID 30 DAYS PRIOR TO ADMISSION AND 90 DAYS POST DISCHARGE. APPROVED SOURCES OF DOCUMENTATION FOR HOMELESS STATUS INCLUDE CHART NOTES, DISCHARGE PLANS, OR DISCHARGE SUMMARIES ENTERED INTO OUR HEALTH INFORMATION SYSTEM BY CARE PROVIDERS OR THE PATIENT INDICATING THEY ARE HOMELESS DURING THE REGISTRATION PROCESS. FINANCIAL ASSISTANCE GRANTED BASED ON THIRD PARTY INFORMATION RATHER THAN A FINANCIAL ASSISTANCE APPLICATION DOES NOT EXTEND TO FUTURE DATES OF SERVICE AND WOULD NEED TO BE REEVALUATED BASED ON INFORMATION AVAILABLE AT THAT TIME. APPLICATION PROCESS & ELIGIBILITY DETERMINATION A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BEFORE, DURING, OR AFTER THE PROVISION OF CARE. THE HOSPITAL HAS DEVELOPED AN APPLICATION PROCESS FOR DETERMINING INITIAL INTEREST IN AND QUALIFICATION FOR FINANCIAL ASSISTANCE. REQUESTS FOR FINANCIAL ASSISTANCE WILL BE ACCEPTED FROM THE PATIENT DIRECTLY, OR OTHERS ON THE PATIENT'S BEHALF. THIS COULD INCLUDE BUT IS NOT LIMITED TO, THE PATIENT'S REPRESENTATIVE, OR HOSPITAL STAFF. -FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATIONS MAY BE DOWNLOADED FROM OUR WEBSITE: HTTP://WWW.SALEMHEALTH.ORG/ABOUT/CHARITY-CARE-AND-FINANCIAL-POLICY -PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATIONS ARE AVAILABLE IN THE EMERGENCY DEPARTMENT, IN REGISTRATION AREAS AND AT PATIENT FINANCIAL SERVICES, 550 HAWTHORNE AVE SE, SUITE 200, SALEM OR 97301 -PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATIONS MAY BE REQUESTED BY MAIL FROM: FINANCIAL COUNSELING, SALEM HEALTH, PO BOX 14001, SALEM OR 97309-9976 OR VIA TELEPHONE BY CALLING 503-562-4357
SALEM HEALTHPART V, SECTION B, LINE 16J: INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE IS BE MADE PUBLICLY AVAILABLE FREE OF CHARGE IN THE FOLLOWING MANNER: 1. NOTICES ARE POSTED IN KEY AREAS OF THE HOSPITAL, INCLUDING ADMITTING, THE EMERGENCY DEPARTMENT, OUTPATIENT DEPARTMENT REGISTRATION AREAS, AND PATIENT FINANCIAL SERVICES. 2. THE CONDITIONS OF ADMISSION FORM INFORMS THE PATIENT OF THEIR RIGHT TO APPLY FOR FINANCIAL ASSISTANCE. 3. WRITTEN INFORMATION IS AVAILABLE IN ENGLISH, SPANISH, RUSSIAN AND VIETNAMESE. THE HOSPITAL WILL PROVIDE THE APPROPRIATE INTERPRETATION SERVICES FOR PATIENTS/GUARANTORS WHO DO NOT SPEAK ENGLISH. 4. FRONT-LINE STAFF ARE TRAINED TO ANSWER FINANCIAL ASSISTANCE QUESTIONS EFFECTIVELY AND WILL DIRECT ANY THAT CANNOT BE ANSWERED TO FINANCIAL COUNSELOR'S IN A TIMELY MANNER. 5. THIS POLICY IS POSTED ON SALEM HEALTH'S WEB SITE. WRITTEN INFORMATION ABOUT THIS POLICY WILL BE MADE AVAILABLE UPON REQUEST. 6. ALL PATIENT BILLING STATEMENTS INCLUDES A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE AND CONTACT INFORMATION IF THEY WANT TO LEARN MORE.
SALEM HEALTHPART V, SECTION B, LINE 18E: IT IS THE POLICY OF SALEM HEALTH TO PURSUE COLLECTION OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR SERVICES. SALEM HEALTH MAKES REASONABLE EFFORTS TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. COLLECTION PROCEDURES ARE APPLIED CONSISTENTLY AND FAIRLY FOR ALL PATIENTS REGARDLESS OF INSURANCE STATUS. ALL COLLECTION PROCEDURES WILL COMPLY WITH APPLICABLE LAWS AND WITH SALEM HEALTH'S MISSION. FOR THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR OPEN BALANCES, THE FINANCIAL ASSISTANCE POLICY WILL BE FOLLOWED. COLLECTION AGENCIES AND/OR LAW FIRMS MAY BE ENLISTED AFTER REASONABLE COLLECTION AND PAYMENT OPTIONS HAVE BEEN EXHAUSTED. AGENCIES MAY HELP RESOLVE ACCOUNTS WHERE PATIENTS ARE UNCOOPERATIVE IN MAKING PAYMENTS, HAVE NOT MADE APPROPRIATE PAYMENTS, OR HAVE BEEN UNWILLING TO PROVIDE REASONABLE FINANCIAL AND OTHER DATA TO SUPPORT THEIR REQUEST FOR FINANCIAL ASSISTANCE. COLLECTION AGENCY AND LAW FIRM STAFF WILL UPHOLD THE CONFIDENTIALITY AND INDIVIDUAL DIGNITY OF EACH PATIENT. ALL AGENCIES AND LAW FIRMS WILL COMPLY WITH ALL APPLICABLE LAWS INCLUDING HIPAA REQUIREMENTS FOR HANDLING PROTECTED HEALTH INFORMATION.
SALEM HEALTHPART V, SECTION B, LINE 19E: SALEM HEALTH WILL NOTIFY INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE INDIVIDUALS AT LEAST 30 DAYS PRIOR TO PURSUING EXTRAORDINARY COLLECTIONS ACTIONS (EAC) AS TO OBTAIN PAYMENT FOR THE CARE PROVIDED BY THE HOSPITAL. ECAS FOR HOSPITAL SERVICES WILL NOT COMMENCE FOR A PERIOD OF AT LEAST 240 DAYS AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT AND 30 DAYS AFTER THE HOSPITAL OR AUTHORIZED THIRD PARTY PROVIDES WRITTEN NOTICE OF ECAS THE HOSPITAL PLANS TO INITIATE FOR THE APPLICABLE MEDICALLY NECESSARY OR EMERGENCY MEDICAL CARE.
SALEM HEALTHPART V, SECTION B, LINE 20E: SALEM HEALTH WILL NOTIFY INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE INDIVIDUALS AT LEAST 30 DAYS PRIOR TO PURSUING EXTRAORDINARY COLLECTIONS ACTIONS AS TO OBTAIN PAYMENT FOR THE CARE PROVIDED BY THE HOSPITAL BY DOING THE FOLLOWING: 1. PROVIDE WRITTEN NOTICE TO THE INDIVIDUAL INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE INDIVIDUALS, INDICATING THAT SALEM HEALTH INTENDS TO INITIATE OR HAVE A THIRD PARTY INITIATE TO OBTAIN PAYMENT FOR THE CARE, AND PROVIDES A DEADLINE AFTER WHICH ECAS MAY BE PURSUED AND WHICH IS NO LATER THAN 30 DAYS AFTER THE DATE OF THIS WRITTEN NOTICE 2. PROVIDE THE INDIVIDUAL A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH THE WRITTEN NOTICE 3. MAKE REASONABLE EFFORTS TO ORALLY NOTIFY INDIVIDUALS ABOUT THE SALEM HEALTH'S FINANCIAL ASSISTANCE POLICY.
SALEM HEALTHPART V, SECTION B, LINE 21C: NOT APPLICABLE- SALEM HEALTH HAS A POLICY RELATIVE TO EMERGENCY MEDICAL CARE THAT REQUIRED THE HOSPITAL FACILITY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY UND THE HOSPITALS FINANCIAL ASSISTANCE POLICY.
SALEM HEALTHPART V, SECTION B, LINE 21D: NOT APPLICABLE- SALEM HEALTH HAS A POLICY RELATIVE TO EMERGENCY MEDICAL CARE THAT REQUIRED THE HOSPITAL FACILITY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY UND THE HOSPITALS FINANCIAL ASSISTANCE POLICY.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - REHABILITATION CENTER
755 MISSION ST SESALEMOR97302REHABILITATION
2 - LABORATORY PHLEBOTOMY SITE - HOPE
1600 STATE STSALEMOR97301LABORATORY SERVICES
3 - COMPREHENSIVE PAIN CENTER
875 OAK STREETSALEMOR97302PAIN MANAGEMENT
4 - REGIONAL LABORATORY
3300 STATE STSALEMOR97301LABORATORY SERVICES
5 - SALEM HEALTH MEDICAL CLINIC - KEIZER
550 DEITZ AVE NEKEIZEROR97303CLINIC
6 - SALEM HEALTH MEDICAL CLINIC - S SALEM
2925 RIVER RD SSALEMOR97302CLINIC
7 - SALEM HEALTH MEDICAL CLINIC - SALEM
966 12TH STREET SESALEMOR97301CLINIC
8 - SALEM HEALTH MEDICAL CLINIC - W SALEM
1049 EDGEWATER ST NW SUITE 150SALEMOR97304CLINIC

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:CRITERIA CONSIDERED IN DETERMINING ELIGIBILITY INCLUDE, BUT ARE NOT LIMITED TO: -THE HOUSEHOLD'S* GROSS INCOME. -HOUSEHOLD'S ASSETS OTHER THAN PRIMARY RESIDENCE ---EQUITY IN A REAL ESTATE (OTHER THAN THE PATIENT/GUARANTOR'S PRIMARY RESIDENCE), SECURITIES OR OTHER ASSETS ARE CONSIDERED AVAILABLE TO PAY THE PATIENT'S MEDICAL EXPENSES AND SHOULD BE INCLUDED IN THE INCOME CALCULATION ---THE INCOME FROM INCOME-PRODUCING REAL PROPERTY SHOULD BE USED IN THE CALCULATION RATHER THAN THE EQUITY. ---INDIVIDUAL RETIREMENT ACCOUNTS (IRAS) OR OTHER RETIREMENT FUNDS WILL NOT BE INCLUDED IN HOUSEHOLD ASSETS; HOWEVER DISTRIBUTIONS FROM THOSE FUNDS WILL BE CONSIDERED INCOME. -FAMILY SIZE (PERSONS LEGALLY RESPONSIBLE FOR THE PATIENT BILL AND THEIR DEPENDENTS) -THE FAMILY'S MONTHLY OUT OF POCKET EXPENSES FOR MEDICAL SUPPLIES AND SERVICES. -ELIGIBILITY MAY BE CONTINGENT UPON PATIENT COOPERATION WITH THE APPLICATION PROCESS. -THE DEFINITION OF 'HOUSEHOLD'S GROSS INCOME' INCLUDES THE COMBINED GROSS MONTHLY INCOME OF ALL PERSONS LEGALLY RESPONSIBLE FOR PATIENT BILL OR BALANCE.SUPPORTING DOCUMENTATION MAY INCLUDE THE FOLLOWING: PATIENT MUST PROVIDE TWO OF THE FOLLOWING DOCUMENTS TO SUPPORT THE INCOME CLAIMS ON THE APPLICATION. -THREE MONTHS INCOME VERIFICATION IN THE FORM OF PAY STUBS, BANK DEPOSITS, ETC. -SOCIAL SECURITY DETERMINATION LETTERS. -THE PRIOR YEAR'S TAX RETURNS OR 4506T-EZ -A "BASIC NEEDS" LETTER THAT INDICATES HOW PERSONS WITH NO INCOME ARE MEETING THEIR DAY TO DAY BASIC LIVING NEEDS. "BASIC NEEDS" LETTER MUST ONLY BE CONSIDERED A SECONDARY SUPPORTING DOCUMENT AFTER THE FINANCIAL COUNSELOR OR CLERK VALIDATES THE INFORMATION. AS OUTLINED IN SALEM HEALTH'S CONDITION OF ADMISSION, A CREDIT BUREAU REPORT OR A CHARITY SCORING VENDOR MAY BE REQUESTED TO VALIDATE INFORMATION PROVIDED ON THE FINANCIAL ASSISTANCE APPLICATION. SALEM HEALTH MAY ACCEPT INFORMATION PROVIDED ON AN OHP APPLICATION, OHP ELIGIBILITY, PROBATE ESTATES DETERMINATION, DOCUMENTATION OF HOMELESS STATUS, OR RELIABLE THIRD PARTY CREDIT INFORMATION AS A SUBSTITUTE FOR THE FINANCIAL FORMS. OHP INFORMATION WILL BE CONSIDERED VALID 30 DAYS PRIOR TO ADMISSION AND 90 DAYS POST DISCHARGE. APPROVED SOURCES OF DOCUMENTATION FOR HOMELESS STATUS INCLUDE CHART NOTES, DISCHARGE PLANS, OR DISCHARGE SUMMARIES ENTERED INTO OUR HEALTH INFORMATION SYSTEM BY CARE PROVIDERS OR THE PATIENT INDICATING THEY ARE HOMELESS DURING THE REGISTRATION PROCESS. FINANCIAL ASSISTANCE GRANTED BASED ON THIRD PARTY INFORMATION RATHER THAN A FINANCIAL ASSISTANCE APPLICATION DOES NOT EXTEND TO FUTURE DATES OF SERVICE AND WOULD NEED TO BE REEVALUATED BASED ON INFORMATION AVAILABLE AT THAT TIME.
PART I, LINE 7:FINANCIAL ASSISTANCE, MEDICAID AND COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS ACCOUNT FOR A LARGE PORTION OF SALEM HEALTH COMMUNITY BENEFIT CONTRIBUTION. ENSURING THAT COMMUNITY MEMBERS HAVE ACCESS TO EMERGENCY, PRIMARY CARE AND OTHER HEALTH SERVICES REGARDLESS OF ABILITY TO PAY, ALIGNS WITH THE HOSPITAL MISSION AND COMMITMENT TO SERVE THOSE LIVING IN MARION AND POLK COUNTIES. SALEM HEALTH IS DEEPLY EMBEDDED IN THE COMMUNITY AND HOSPITAL LEADERS WORK HAND IN HAND WITH REPRESENTATIVES FROM GOVERNMENT AGENCIES AND OTHER NON-PROFITS TO ASSESS AND ADDRESS COMMUNITY NEEDS. FOUR COMMUNITY WIDE TASK FORCES ARE IN PLACE TO ADDRESS THE FOUR HEALTH NEEDS DEEMED MOST CRITICAL IN MARION AND POLK COUNTY. THOSE ARE EARLY CHILDHOOD HEALTH INCLUDING PRENATAL CARE, TOBACCO AND SUBSTANCE ABUSE, DEPRESSION SCREENING AND OBESITY PREVENTION. THE HOSPITAL'S DIRECTOR OF COMMUNITY BENEFIT ATTENDS TASK FORCE MEETINGS AND LOOKS FOR WAYS TO LEVERAGE HOSPITAL RESOURCES TO IMPACT HEALTH OUTCOMES. HOSPITAL LEADERS VOLUNTEER TIME TO SERVE ON COMMUNITY NON-PROFIT BOARDS AND ATTEND REGIONAL COLLABORATIVE WORKGROUPS THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH. EXAMPLES INCLUDE, BOARD POSITIONS ON THE EARLY LEARNING HUB, WITH A FOCUS ON KINDERGARTEN READINESS; THE MID-WILLAMETTE VALLEY HOMELESS INITIATIVE; AND SALEM KEIZER SPECIAL TRANSPORTATION ADVISORY GROUP.THE HOSPITAL PROVIDES COMMUNITY BASED HEALTH IMPROVEMENT SERVICES AS REQUESTED IN MARION AND POLK COUNTIES. IN 2016-2017 THESE INCLUDING HEALTH SCREENINGS, EDUCATION AND OUTREACH. THE EDUCATION CENTER OFFERS A LENDING LIBRARY, DROP IN NURSING CONSULTATION SERVICES, HEALTH SCREENINGS AND GROUP INSTRUCTION. IN ADDITION, THE CENTER PROVIDES SPACE FREE OF CHARGE TO COMMUNITY PARTNERS SEEKING TO IMPROVE HEALTH OUTCOMES. THE ROOMS HOST CLASSES, LECTURES, HEALTH FAIRS AND SUPPORT GROUPS THAT ARE COORDINATED IN PARTNERSHIP WITH COMMUNITY AGENCIES.SALEM HEALTH PROVIDED COMMUNITY PARTNERSHIP GRANTS IN 2016. THESE GRANTS SUPPORT THE WORK OF COMMUNITY PARTNERS THAT ARE ADDRESSING THE IDENTIFIED HEALTH NEEDS FROM THE 2015 COMMUNITY NEEDS ASSESSMENT. LASTLY, THE HOSPITAL PROVIDES TRAINING FOR NURSING STUDENTS AND EMERGING HEALTH CARE PROFESSIONS. IT HEALTH CAREER EXPLORATION PROGRAMS FOR HIGH SCHOOL STUDENTS IN DISTRICTS THAT FALL WITHIN THE HOSPITAL CATCHMENT AREA OF MARION AND POLK COUNTIES.
PART I, LN 7 COL(F):THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSE THAT WAS INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A), BUT REMOVED FROM THIS FIGURE FOR THE PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS $36,727,074.
PART I, LINE 6AA COMMUNITY BENEFIT REPORT WAS PREPARED DURING THE TAX YEAR AND CAN BE FOUND ON THE SALEM HEALTH WEBSITE AT WWW.SALEMHEALTH.ORG
PART II, COMMUNITY BUILDING ACTIVITIES:SALEM HEALTH HAS MORE THAN 450 VOLUNTEERS AND A STAFF OF THREE THAT COORDINATE COMMUNITY BUILDING ACTIVITIES. VOLUNTEERS RAISE MONEY FOR COMMUNITY SCHOLARSHIPS, COORDINATE JOB SHADOW OPPORTUNITIES AND ARRANGE BLOOD DRIVES. LEADERS AT ALL LEVELS WITHIN SALEM HEALTH SERVE ON COMMUNITY BOARDS AND TASK FORCES THAT ADDRESS COMMUNITY NEEDS. THE HOSPITAL HAS BEEN ACTIVELY RECRUITING PRIMARY CARE PROVIDERS TO MARION AND POLK COUNTIES TO IMPROVE ACCESS TO CARE. SALEM HEALTH OFFERS PHYSICIAN LEADERSHIP TRAINING TO COMMUNITY PROVIDERS AND LEADERSHIP DEVELOPMENT COURSES THAT ARE MADE AVAILABLE TO LEADERS ACROSS THE SERVICE AREA.
PART III, LINE 2:BAD DEBT EXPENSE IS PRIMARILY ESTIMATED BASED UPON THE HOSPITALS' HISTORICAL COLLECTION EXPERIENCE, THE AGE OF THE PATIENT'S ACCOUNT, THE PATIENT'S ECONOMIC ABILITY TO PAY, AND THE EFFECTIVENESS OF COLLECTION EFFORTS. PATIENT ACCOUNTS RECEIVABLE BALANCES ARE ROUTINELY REVIEWED IN CONJUNCTION WITH HISTORICAL COLLECTION RATES AND OTHER ECONOMIC CONDITIONS THAT MIGHT ULTIMATELY AFFECT THE COLLECTABILITY OF PATIENT ACCOUNTS WHEN CONSIDERING THE ADEQUACY OF THE AMOUNTS RECORDED IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACTUAL WRITE-OFFS HISTORICALLY HAVE APPROXIMATED MANAGEMENT'S EXPECTATIONS.
PART III, LINE 3:BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER SALEM HEALTH'S FINANCIAL ASSISTANCE POLICY, IS ESTIMATED BASED ON DATA FROM OUR PATIENT ACCOUNTING SYSTEM. THIS DATA IS THEN COMPARED AND MATCHED TO MEDIAN HOUSEHOLD INCOME CENSUS DATA BY ZIP CODE TO DETERMINE THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE
PART II, LINE 8:SALEM HEALTH HAS BEEN ACTIVELY RECRUITING PRIMARY CARE PROVIDERS TO MARION AND POLK COUNTIES TO IMPROVE ACCESS TO CARE.
PART IISALEM HEALTH HAS MORE THAN 450 VOLUNTEERS AND A STAFF OF THREE THAT COORDINATE COMMUNITY BUILDING ACTIVITIES. VOLUNTEERS RAISE MONEY FOR COMMUNITY SCHOLARSHIPS, COORDINATE JOB SHADOW OPPORTUNITIES AND ARRANGE BLOOD DRIVES.LEADERS AT ALL LEVELS WITHIN SALEM HEALTH SERVE ON COMMUNITY BOARDS AND TASK FORCES THAT ADDRESS COMMUNITY NEEDS.THE HOSPITAL HAS BEEN ACTIVELY RECRUITING PRIMARY CARE PROVIDERS TO MARION AND POLK COUNTIES TO IMPROVE ACCESS TO CARE. SALEM HEALTH OFFERS PHYSICIAN LEADERSHIP TRAINING TO COMMUNITY PROVIDERS AND LEADERSHIP DEVELOPMENT COURSES THAT ARE MADE AVAILABLE TO LEADERS ACROSS THE SERVICE AREA.
PART III, LINE 4:EFFECTIVE OCTOBER 1, 2011, THE HOSPITALS ADOPTED FASB ISSUED ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, HEALTH CARE ENTITIES (TOPIC 954): PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES. THE ADOPTION OF THIS ASU RESULTED IN A RECLASSIFICATION OF BAD DEBT EXPENSE FROM AN OPERATING EXPENSE TO BE A REDUCTION IN DERIVING NET PATIENT SERVICE REVENUE. THE ALLOWANCES FOR DOUBTFUL ACCOUNTS ARE PRIMARILY ESTIMATED BASED UPON THE HOSPITALS' HISTORICAL COLLECTION EXPERIENCE, THE AGE OF THE PATIENT'S ACCOUNT, THE PATIENT'S ECONOMIC ABILITY TO PAY, AND THE EFFECTIVENESS OF COLLECTION EFFORTS. PATIENT ACCOUNTS RECEIVABLE BALANCES ARE ROUTINELY REVIEWED IN CONJUNCTION WITH HISTORICAL COLLECTION RATES AND OTHER ECONOMIC CONDITIONS THAT MIGHT ULTIMATELY AFFECT THE COLLECTABILITY OF PATIENT ACCOUNTS WHEN CONSIDERING THE ADEQUACY OF THE AMOUNTS RECORDED IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACTUAL WRITE-OFFS HISTORICALLY HAVE APPROXIMATED MANAGEMENT'S EXPECTATIONS.
PART III, LINE 8:MEDICARE PAYS A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR ENROLLEES SUCH THAT THE NET REIMBURSEMENT DOES NOT COVER THE EXPENSES INCURRED TO PROVIDE THE SERVICES. SALEM HEALTH CONSIDERS THE DIFFERENCE BETWEEN THE COSTS TO PROVIDE THE SERVICES FOR MEDICARE ENROLLEES AND THE NET REIMBURSEMENT AS A BENEFIT TO THE COMMUNITY. MEDICARE FEE-FOR-SERVICE COSTS ARE DETERMINED FROM SALEM HEALTH'S FILED MEDICARE COST REPORT. THE CALCULATION OF NET BENEFIT IS EQUAL TO TOTAL MEDICARE PAYMENTS LESS MEDICARE COSTS.IN ADDITION TO TRADITIONAL MEDICARE FEE-FOR-SERVICE, SALEM HEALTH PROVIDES SUBSTANTIAL SERVICES TO OTHER MEDICARE POPULATIONS PARTICIPATING IN MEDICARE ADVANTAGE PLANS AT SIGNIFICANTLY REDUCED REIMBURSEMENT. THE NET REVENUES FOR THESE PLANS ARE LESS THAN THE COST TO PROVIDE CARE AND ARE NOT DISCLOSED IN PART III, LINE 8. SALEM HEALTH ALSO CONSIDERS THE DIFFERENCE BETWEEN THE NET COST TO PROVIDE CARE FOR MEDICARE ADVANTAGE ENROLLEES AND THE NET REIMBURSEMENT AS A BENEFIT TO THE COMMUNITY. THESE NET COSTS HAVE BEEN DETERMINED BY APPLYING THE RATIO OF COSTS TO CHARGES AS DETERMINED IN WORKSHEET 2 TO THE FULL BILLED CHARGES. THE CALCULATION OF NET BENEFIT IS EQUAL TO TOTAL MEDICARE ADVANTAGE PAYMENTS OF $154,301,793 LESS MEDICARE ADVANTAGE COSTS OF $182,654,129 FOR A TOTAL ADDITIONAL COMMUNITY BENEFIT IN THE AMOUNT OF $28,352,336.
PART III, LINE 9B:THE BILLING AND COLLECTIONS ADMINISTRATIVE HOUSE-WIDE POLICY AND PROCEDURE STATES, "IF A PATIENT SUBMITS A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, SALEM HEALTH WILL SUSPEND THE ECAS UNTIL THE PATIENT'S APPLICATION HAS BEEN PROCESSED AND NOTIFY THE PATIENT OF DETERMINATION. IF AN INDIVIDUAL IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ANY ECAS WILL BE REVERSED.
PART VI, LINE 2:A COMPREHENSIVE NEEDS ASSESSMENT WAS CONDUCTED IN TAX YEAR 2015. THE NEEDS ASSESSMENT DESCRIBES THE COMMUNITY SERVED BY THE HOSPITAL AND THE DEMOGRAPHICS OF THE COMMUNITY. IT DOES NOT DESCRIBE THE EXISTING HEALTH CARE FACILITIES AND RESOURCES WITHIN THE COMMUNITY THAT ARE AVAILABLE TO RESPOND TO NEEDS. THE MARION AND POLK COUNTY HEALTH CARE SYSTEM CAPACITY AND ACCESS ASSESSMENT CONTAINS HEALTH CARE FACILITY AND RESOURCE INFORMATION. THE CAPACITY AND ACCESS ASSESSMENT IS UPDATED ANNUALLY. THE LATEST CHNA AND HEALTH CARE SYSTEM CAPACITY AND ACCESS ASSESSMENTS ARE PUBLISHED TO THE SALEM HEALTH WEBSITE AT WWW.SALEMHEALTH.ORG. THE NATIONAL MODEL, MOBILIZATION FOR ACTION THROUGH PLANNING AND PARTNERSHIPS OR MAPP WAS USED AS THE FRAMEWORK FOR THE COMMUNITY HEALTH ASSESSMENT. THE FOUR ASSESSMENTS OF THE MAPP FRAMEWORK INCLUDE: COMMUNITY THEMES AND STRENGTHS, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, COMMUNITY HEALTH STATUS ASSESSMENT AND THE FORCES OF CHANGE ASSESSMENT.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT WAS CONDUCTED BY SURVEYING COMMUNITY PARTNERS WORKING IN SOCIAL, HEALTH, COMMUNITY, EDUCATIONAL AND CORRECTIONAL HEALTH SETTINGS AND THE COMMUNITY-AT-LARGE. THE SURVEYS USED IN BOTH MARION AND POLK COUNTIES CONSISTED OF THE SAME QUESTIONS AND USED THE 2011 MARION COUNTY SURVEY AS A TEMPLATE. PAPER AND ELECTRONIC SURVEYS WERE ALLOCATED BASED ON POPULATION DISTRIBUTION THROUGHOUT OUR COMMUNITIES. THE COMMUNITY HEALTH STATUS ASSESSMENT WAS CONDUCTED BY COMPILING DATA FROM NATIONAL SURVEILLANCE SYSTEMS LIKE THE BEHAVIOR RISK FACTOR SURVEILLANCE SURVEY AND OREGON HEALTHY TEENS AS WELL AS STATE AND LOCAL DATA FROM BIRTH AND DEATH CERTIFICATES. IN ADDITION, AS SERIES OF COMMUNITY CAF S WERE CONDUCTED ACROSS MARION AND POLK COUNTY TO IDENTIFY HEALTH PRIORITIES.SALEM HEALTH HOSTED COMMUNITY CAF S AND REPRESENTATIVES FROM MARION AND POLK COUNTY PUBLIC HEALTH, PRESENTED CHNA FINDINGS TO THE SALEM HEALTH COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF TRUSTEES IN NOVEMBER 2015. THE MARION AND POLK COUNTY HEALTH REPORTS WAS PUBLISHED IN DECEMBER 2015 AND CAN BE FOUND ON THE SALEM HEALTH WEBSITE. WWW.SALEMHEALTH.ORG. THE DOCUMENT INFORMED THE DEVELOPMENT OF THE COMMUNITY BENEFIT IMPLEMENTATION STRATEGY FOR REPORTING YEARS 2015 - 2017, ALSO AVAILABLE ON THE WEBSITE.THE IMPACT OF ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITIES PRIOR CHNAS CAN BE FOUND ON THE COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) ANNUALLY REPORT. THE CHIP IS COORDINATED BY THE MARION COUNTY PUBLIC HEALTH DEPARTMENT AND IS PUBLISHED ON THEIR WEBPAGE AT HTTP://WWW.CO.MARION.OR.US/HLT/CHIP/PAGES/DEFAULT.ASPX.
PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESALEM HEALTH SCREENS UNINSURED PATIENTS FOR ELIGIBILITY THROUGH THE OREGON HEALTH PLAN (OHP/MEDICAID), WORKERS COMPENSATION, THIRD PARTY LIABILITIES, CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA), OR ANY OTHER POTENTIAL FUNDING SOURCE AT THE POINT OF SCHEDULING, PATIENT REGISTRATION OR WHILE INPATIENT. THE HOSPITAL OR ITS REPRESENTATIVE WILL REVIEW THE PATIENT'S CURRENT RESOURCES AND WORK WITH HIM/HER TO GAIN ELIGIBILITY FOR ANY OF THESE PROGRAMS AS APPROPRIATE. PATIENTS THAT ARE NOT ELIGIBLE FOR OHP OR THE OTHER PROGRAMS LISTED ABOVE, AND HAVE FINANCIAL CONSTRAINTS THAT INHIBIT THEIR ABILITY TO PAY, WILL BE ASSESSED FOR A FINANCIAL ASSISTANCE. INFORMATION REGARDING THE HOSPITAL'S FINANCIAL ASSISTANCE IS MADE PUBLICLY AVAILABLE IN THE FOLLOWING MANNER: 1. NOTICES ARE POSTED IN KEY AREAS OF THE HOSPITAL, INCLUDING ADMITTING, THE EMERGENCY DEPARTMENT, OUTPATIENT DEPARTMENT REGISTRATION AREAS, AND PATIENT FINANCIAL SERVICES. 2. THE CONDITIONS OF ADMISSION FORM INFORMS THE PATIENT OF THEIR RIGHT TO APPLY FOR FINANCIAL ASSISTANCE. 3. WRITTEN INFORMATION SHALL BE AVAILABLE IN ENGLISH, SPANISH, RUSSIAN AND VIETNAMESE. THE HOSPITAL WILL PROVIDE THE APPROPRIATE INTERPRETATION SERVICES FOR PATIENTS/GUARANTORS WHO DO NOT SPEAK ENGLISH. 4. FRONT-LINE STAFF WILL BE TRAINED TO ANSWER FINANCIAL ASSISTANCE QUESTIONS EFFECTIVELY AND WILL DIRECT ANY THAT CANNOT BE ANSWERED TO FINANCIAL COUNSELOR'S IN A TIMELY MANNER. 5. THIS POLICY WILL BE POSTED ON SALEM HEALTH'S WEB SITE. WRITTEN INFORMATION ABOUT THIS POLICY WILL BE MADE AVAILABLE UPON REQUEST. 6. ALL PATIENT BILLING STATEMENTS WILL INCLUDE A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE AND CONTACT INFORMATION IF THEY WANT TO LEARN MORE
PART VI, LINE 4:SALEM HEALTH SERVES MARION AND POLK COUNTIES.IN 2016, THERE WERE 79,291 PEOPLE AND 28,458 HOUSEHOLDS RESIDING IN THE POLK COUNTY. THE RURAL COMMUNITY HAD A POPULATION DENSITY OF 101.8 INHABITANTS PER SQUARE MILE (39.3/KM2). THERE WERE 31,166 HOUSING UNITS. THE RACIAL MAKEUP OF THE COUNTY WAS 90.7% WHITE, 2.6% AMERICAN INDIAN, 2.0% ASIAN, 0.9% BLACK OR AFRICAN AMERICAN, 0.4% PACIFIC ISLANDER AND 3.5% FROM TWO OR MORE RACES. THOSE OF HISPANIC OR LATINO ORIGIN MADE UP 13% OF THE POPULATION. 7.5% OF THE POPULATION IS FOREIGN BORN. THE AVERAGE HOUSEHOLD SIZE WAS 2.62. 5.9% OF THE POPULATION ARE UNDER THE AGE OF 5 YEARS, 23.5% ARE UNDER THE AGE OF 18 AND 16.4% ARE OVER THE AGE OF 65 YEARS. THE MEDIAN INCOME FOR A HOUSEHOLD IN POLK COUNTY IS $52,821. THE PER CAPITA INCOME FOR THE COUNTY WAS $23,967. ABOUT 13.7% OF THE POPULATION LIVE BELOW THE POVERTY LINE. ACCORDING TO THE U.S. CENSUS BUREAU, MARION COUNTY HAS A TOTAL AREA OF 744 SQUARE MILES (1,930 KM2), OF WHICH 741 SQUARE MILES (1,920 KM2) IS LAND AND 3.1 SQUARE MILES (8.0 KM2) (0.4%) IS WATER. THE MAJOR INDUSTRIES OF THE COUNTY ARE AGRICULTURE, FOREST PRODUCTS, MANUFACTURING, AND EDUCATION. POLK COUNTY HAS THE SECOND-LARGEST AREA DEVOTED TO VITICULTURE IN OREGON, AT 1,322 ACRES (5.35 KM2).IN 2016 THERE WERE 330,700 PEOPLE AND 113,996 HOUSEHOLDS RESIDING IN THE MARION COUNTY. THE COUNTY IS A BLEND OF URBAN AND RURAL WITH A POPULATION DENSITY OF 266.7 INHABITANTS PER SQUARE MILE (39.3/KM2). THERE WERE 123,467 HOUSING UNITS. THE RACIAL MAKEUP OF THE COUNTY WAS 89.4% WHITE, 2.6% AMERICAN INDIAN, 2.3% ASIAN, 1.4% BLACK OR AFRICAN AMERICAN, 1.0% PACIFIC ISLANDER AND 3.3% FROM TWO OR MORE RACES. THOSE OF HISPANIC OR LATINO ORIGIN MADE UP 26% OF THE POPULATION. 7.5% OF THE POPULATION IS FOREIGN BORN. THE AVERAGE HOUSEHOLD SIZE WAS 2.62. 5.9% OF THE POPULATION ARE UNDER THE AGE OF 5 YEARS, 23.5% ARE UNDER THE AGE OF 18 AND 16.4% ARE OVER THE AGE OF 65 YEARS. THE MEDIAN INCOME FOR A HOUSEHOLD IN MARION COUNTY IS $48,832. THE PER CAPITA INCOME FOR THE COUNTY WAS $22,490. ABOUT 16.8% OF THE POPULATION LIVE BELOW THE POVERTY LINE. ACCORDING TO THE U.S. CENSUS BUREAU, THE COUNTY HAS A TOTAL AREA OF 1,193 SQUARE MILES (3,090 KM2), OF WHICH 1,182 SQUARE MILES (3,060 KM2) IS LAND AND 10 SQUARE MILES (26 KM2) (0.9%) IS WATER. AGRICULTURE AND FOOD PROCESSING ARE IMPORTANT TO THE COUNTY'S ECONOMY, AS ARE LUMBER, MANUFACTURING, AND EDUCATION. MARION COUNTY IS THE LEADER IN AGRICULTURAL PRODUCTION AMONG ALL OTHER OREGON COUNTIES
PART VI, LINE 5:SALEM HEALTH FUNDS A COMMUNITY HEALTH EDUCATION AND OUTREACH PROGRAM. THE CENTER IS STAFFED BY HEALTH EDUCATORS AND REGISTERED NURSES THAT PROVIDE EDUCATION SERVICES TO COMMUNITY MEMBERS ON A DROP IN BASIS. A MEDICAL PROFESSIONAL AND HEALTH CONSUMER LIBRARY ALLOWS PATRONS TO CHECK OUT HEALTH MATERIALS FREE OF CHARGE. THE LIBRARY SUPPORTS COMMUNITY PROVIDERS, HEALTH PROFESSIONAL AND STUDENTS THAT LIVE, WORK AND LEARN IN MARION AND POLK COUNTIES.MORE THAN 1500 CLASSES AND EVENTS ARE HELD AT THE CENTER AND IN THE COMMUNITY EACH YEAR TO PROMOTE HEALTH AND PREVENT CHRONIC CONDITIONS. THESE RANGE FROM PREVENTION AND EARLY DETECTION/SCREENING SERVICES TO CHRONIC DISEASE MANAGEMENT AND END OF LIFE DECISION SUPPORT. THE OUTREACH PRIORITIES SUPPORT THE CHNA AND STAFF WORK IN COLLABORATION WITH COMMUNITY PARTNERING AGENCIES TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES AND INDIVIDUALS WITHIN MARION AND POLK COUNTIES. THE HOSPITAL EXECUTIVE TEAM MEMBERS INTENTIONALLY SERVE ON NON-PROFIT BOARDS THROUGHOUT MARION AND POLK COUNTIES. THESE INCLUDE THE UNITED WAY, MARION POLK FOOD SHARE, FAMILY BUILDING BLOCKS, LIBERTY HOUSE AND THE LOCAL COORDINATED CARE ORGANIZATION, AMONG OTHERS. THESE ORGANIZATIONS SERVE VULNERABLE POPULATIONS. OFTEN COMMUNITY BENEFIT ACTIVITIES, ESPECIALLY CASH AND IN-KIND DONATIONS,SUPPORT THE WORK OF PARTNERING ORGANIZATIONS TO MEET THE IDENTIFIED NEEDS OF THE UNDERSERVED IN OUR COMMUNITY. THE COMMUNITY PARTNERSHIP GRANT PROGRAM PROMOTES THE HEALTH AND WELL-BEING OF LOW-INCOME INDIVIDUALS AND FAMILIES IN MARION AND POLK COUNTIES THROUGH FUNDING PROJECTS THAT ADDRESS HEALTH RELATED PRIORITIES IDENTIFIED IN THE CHNA. IN 2016, NEARLY $300,000 WAS DISSEMINATED TO COMMUNITY PARTNERS TO ADDRESS EARLY CHILDHOOD HEALTH, DEPRESSION, SUBSTANCE USE DISORDER AND OBESITY.
PART VI, LINE 6:SALEM HEALTH IS AN OREGON NONPROFIT CORPORATION AND A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. SALEM HEALTH, HOSPITALS AND CLINICS IS THE "PARENT" CORPORATION AND SOLE CORPORATE MEMBER OF SALEM HEALTH, SALEM HEALTH FOUNDATION, SALEM HEALTH WEST VALLEY, WEST VALLEY HOSPITAL FOUNDATION, WILLAMETTE VALLEY INSURANCE CORPORATION, AND SALEM HEALTH PROFESSIONAL SERVICES. ALL ENTITIES WITHIN THE PARENT CORPORATION ARE SEPARATE NONPROFIT CORPORATIONS.SALEM HEALTH IS AN OREGON NONPROFIT CORPORATION AND A TAX-EXEMPT ORGANIZATION. THE CORPORATION ALSO DOES BUSINESS UNDER THE NAME "SALEM HEALTH, A PART OF SALEM HEALTH HOSPITALS AND CLINICS." SALEM HEALTH IS ONE OF THE LARGEST ACUTE CARE HOSPITALS IN OREGON. LICENSED FOR 494 BEDS, SALEM HEALTH OFFERS A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES AN AREA OF OVER 500,000 PEOPLE, INCLUDING ALL OF MARION AND POLK AND PORTIONS OF LINN AND YAMHILL COUNTIES INCLUDING THE RESIDENTS OF THE CITY OF SALEM, THE STATE CAPITAL OF OREGON.SALEM HEALTH IS THE LARGEST PRIVATE EMPLOYER IN SALEM, OREGON, WITH APPROXIMATELY 4,189 FULL AND PART-TIME EMPLOYEES (AS OF JUNE 30, 2017). THE MEDICAL STAFF IS COMPRISED OF APPROXIMATELY 482 PHYSICIANS REPRESENTING MORE THAN 50 SPECIALTIES AND SUBSPECIALTIES, AND MORE THAN 300 VOLUNTEERS PROVIDE NON-MEDICAL SUPPORT FOR SALEM HEALTH.SALEM HEALTH, AS PART OF SALEM HEALTH HOSPITALS AND CLINICS IS GOVERNED BY AN ALL-VOLUNTEER COMMUNITY-BASED BOARD OF TRUSTEES (BOARD). THE BOARD HAS THE RESPONSIBILITY FOR THE DEVELOPMENT AND OVERSIGHT OF SALEM HEALTH VALUES, VISION, PURPOSE AND LONG-TERM STRATEGY. THROUGH THESE DOCUMENTS, THE COMMUNITY BENEFIT STEERING COMMITTEE ASSESSES AND REAFFIRMS SALEM HEALTH'S COMMUNITY BENEFIT COMMITMENTS AND CONNECTIONS WITH COMMUNITY NEEDS AND PRIMARY CONSTITUENCIES. THE COMMUNITY BENEFIT PLAN ASSURES MEASUREMENT AND COMPARISON OF SALEM HEALTH'S COMMUNITY ACTIVITIES TO EVOLVING NORMS AND OVERSEES THE CLEAR AND ACCURATE COMMUNICATION OF THESE ACTIVITIES TO KEY CONSTITUENCIES.
PART VI, LINE 7, REPORTS FILED WITH STATESOR
PART VI, LINE 6:AFFILIATED HEALTH CARE SYSTEMSALEM HEALTH, AS PART OF SALEM HEALTH HOSPITALS AND CLINICS, WAS AFFILIATED WITH OREGON HEALTH SCIENCE UNIVERSITY (OHSU). CHANGES IN PRIORITIES AND PROCESSES REQUIRING COURSE CORRECTIONS ARE COMMON IN THE FIRST YEARS OF AN AFFILIATION AND THE CONCLUSION WAS REACHED BY BOTH THE CORPORATION AND OHSU THAT THE JMA WAS NOT WORKING IN THE WAY ORIGINALLY INTENDED. THE PARTIES RECOGNIZED THE NEED FOR A TRANSITION. AS A RESULT, THE CORPORATION AND OHSU ENTERED IN TO A TRANSITION AGREEMENT THAT TERMINATED THE JMA EFFECTIVE MAY 4, 2017 WITH EACH PARTY REASSUMING OVERSIGHT AND FULL MANAGEMENT OF THEIR OWN CLINICAL ENTERPRISES AND THE CORPORATION TRANSFERRING ITS INTEREST IN OHSU PARTNERS TO OHSU.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtNon Cash AssistanceNonCashAssistanceAmt
MEDICAL FOUNDATION OF MARION & POLK COUNTIES
2995 RYAN DRIVE STE 100SALEMOR97301931261633501(C)(3)$17,500SPONSORSHIP OF ANNUAL BENEFIT FUNDRAISER/IMPROVE ACCESS TO HEALTHCARE
AMERICAN CANCER SOCIETY
2120 1ST AV NSEATTLEWA98121841316555501(C)(3)$5,000RELAY FOR LIFE SPONSORSHIP/IMPROVE SOCIAL DETERMINATE OF HEALTH
MARCH OF DIMES
1220 SW MORRISON SUITE 510PORTLANDOR97205131846366501(C)(3)$10,000SPONSOR FOR SALEM MARCH FOR BABIES/IMPROVE SOCIAL DETERMINATE OF HEALTH
SALEM HEALTH FOUNDATION
PO BOX 14001SALEMOR97309237002687501(C)(3)$5,000CHARITABLE CONTRIBUTION GOLF TOURNAMENT
SALEM KEIZER EDUCATION FOUNDATION
233 COMMERCIAL STREET NESALEMOR97301930831467501(C)(3)$25,000AWESOME 3000 SPONSORSHIP/DISEASE PREVENTION
BOYS & GIRLS CLUB
1395 SUMMER ST NESALEMOR97301930581470501(C)(3)$37,500COMMUNITY PARTNER GRANT/IMPROVE SOCIAL DETERMINATE OF HEALTH
LIBERTY HOUSE
2685 4TH ST NESALEMOR97301931236936501(C)(3)$5,000CHEFS FOR LIBERTY HOUSE SPONSORSHIP/CHAMPIONS FOR CHILDREN SPONSORSHIP
SALVATION ARMY
1901 FRONT STSALEMOR97301941156347501(C)(3)$25,000COMMUNITY PARTNER GRANT
UNITED WAY OF MID WILLAMETTE VALLEY
455 BLILER AVE NESALEMOR97303930395586501(C)(3)$7,500SPONSOR BINATIONAL HEALTH FAIR/PRESIDENT'S LEADERSHIP CIRCLE/IMPROVE SOCIAL DETERMINATE OF HEALTH
SALEM FREE MEDICAL CLINIC
1300 BROADWAY ST NE STE 104SALEMOR97301203549992501(C)(3)$75,000ACCESS TO CARE (SALEM & DALLAS)
SALEM INTERFAITH HOSPITALITY NETWORK
1055 EDGEWATER ST NWSALEMOR97304931234367501(C)(3)$18,250COMMUNITY PARTNER GRANT
POLK CO FAMILY & COMMUNITY OUTREACH
182 SW ACADEMY STREET 220DALLASOR97338936002310MUNICIPAL$25,000COMMUNITY PARTNER GRANT
MANO A MANO FAMILY CENTER
2921 SADDLE CLUB SE 1009SALEMOR97317930992858501(C)(3)$25,000COMMUNITY PARTNER GRANT
AMERICAN DIABETES ASSOCIATION
4380 SW MACADAM AV210PORTLANDOR97239131623888501(C)(3)$24,796COMMUNITY PARTNER GRANT/IMPROVE SOCIAL DETERMINATE TO HEALTH
FAMILY BUILDING BLOCKS
2425 LANCASTER DR NESALEMOR97305931233373501(C)(3)$46,370COMMUNITY PARTNER GRANT
GILBERT HOUSE
116 MARION ST NESALEMOR97301930948548501(C)(3)$5,000EXHIBIT SPONSOR - ALL ABOUT ME
MARION COUNTY
PO BOX 14500SALEMOR97309936002307$25,000COMMUNITY PARTNER GRANT/IMPROVE SOCIAL DETERMINATE TO HEALTH
MARION POLK FOOD SHARE
1660 SALEM INDUSTRIAL DRIVE NESALEMOR97301943034161501(C)(3)$19,971COMMUNITY PARTNER GRANT/IMPROVE SOCIAL DETERMINATE TO HEALTH
MWVCAA
2585 STATE STSALEMOR97301237056987501(C)(3)$12,500COMMUNITY PARTNER GRANT
OHSU
3181 SW SAM JACKSON PARK RDPORTLANDOR97239237083114$5,000SPONSORSHIP OF GOLF TOURNAMENT
PSYCHIATRIC CRISIS CENTER
PO BOX 14500SALEMOR97309936002307ACCESS TO MEDICAL SERVICES$16,485
FieldValueIRS element (for citing)
Total501c3 Org22Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
CASH ASSISTANCE TO PATIENTS IN NEED FOR PRESCRIPTIONS, LIFELINE SUPPORT, REHABILITATION AND OTHER URGENT NEEDS.98$20,270
SCHOLARSHIPS FOR HEALTH PROFESSIONS EDUCATION64$122,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANTS ARE ONLY MADE TO QUALIFIED EXEMPT ORGANIZATIONS. NO MONITORING IS REQUIRED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CHERYL NESTER WOLFE
PRESIDENT AND CEO$579,665$0$143,292$0$7,341$0$57,385$0$15,229$0$802,912$0$0$0
JAMES PARR
CHIEF FINANCIAL OFFICER$398,813$0$38,833$0$1,407$0$45,500$0$35,831$0$520,384$0$0$0
RALPH YATES
CMO SALEM HEALTH AND SHMG$395,536$0$37,659$0$13,076$0$42,293$0$28,279$0$516,843$0$0$0
LAURIE BARR
VP HUMAN RESOURCES$332,579$0$49,020$0$1,668$0$41,367$0$34,387$0$459,021$0$0$0
SARAH HORN
CHIEF NURSING OFFICER$303,412$0$26,681$0$999$0$39,435$0$33,934$0$404,461$0$0$0
LEAH MITCHELL
CIO - EFF 9/4/16$362,791$0$43,386$0$1,112$0$43,756$0$17,830$0$468,875$0$0$0
LORI JAMES-NIELSEN TERM 31717
SEE SCHEDULE J$339,834$0$33,909$0$2,558$0$46,667$0$33,994$0$456,962$0$0$0
ANDREW FURMAN
VP MEDICAL AFFAIRS$339,040$0$26,180$0$1,269$0$24,943$0$33,775$0$425,207$0$0$0
BAHAA WANLY
CHIEF OPERATING OFFICER$273,016$0$30,295$0$930$0$30,282$0$32,775$0$367,298$0$0$0
DENISE HOOVER
VP SURGICAL SERVICES$186,850$0$18,722$0$344$0$26,970$0$20,819$0$253,705$0$0$0
SHEA CORUM
VP IT OPERATIONS - EFF 10/16/16$150,901$0$5,000$0$158$0$11,060$0$30,748$0$197,867$0$0$0
LEILANI SLAMA
VP COMMUNITY ENGAGEMENT$137,445$0$13,591$0$353$0$12,359$0$29,264$0$193,012$0$0$0
NORMAN GRUBER
SEE SCHEDULE J - TERM 7/3/16$523,175$0$1,722,873$0$8,085$0$419,875$0$48,695$0$2,722,703$0$0$0
JUAN OYARZUN - EFF 21917
DIRECTOR OF CARDIOTHORACIC MEDICINE$1,235,741$0$0$0$4,525$0$41,873$0$39,400$0$1,321,539$0$0$0
JASWINDER KAUR
ADULT HOSPITALIST PHYSICIAN$497,808$0$26,843$0$796$0$17,225$0$36,073$0$578,745$0$0$0
NERVIN FANOUS
CARDIOTHORACIC SURGEON$782,005$0$0$0$849$0$22,952$0$30,322$0$836,128$0$0$0
NICOLE VANDERHEYDEN MD
TRAUMA DIR/ ASSOC CMO SHMG$715,461$0$31,022$0$5,977$0$49,205$0$40,524$0$842,189$0$0$0
JAMES SAPIENZA
FMR CAO OF SHWV$37,701$0$15,762$0$232,637$0$1,951$0$15,071$0$303,122$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINES 4A-BSEVERANCE PAYMENTS WERE MADE TO JAMES SAPIENZA ($232,329) WHICH HAS BEEN INCLUDED IN 'OTHER REPORTABLE COMPENSATION'. SOME OF THE HOSPITAL'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) RALPH YATES $27,718 (INCLUDED IN DEFERRED COMPENSATION) LAURIE BARR $40,606 ($19,114 INCLUDED IN BONUS & INCENTIVE COMPENSATION AND $21,492 INCLUDED IN DEFERRED COMPENSATION) SARAH HORN $19,560 (INCLUDED IN DEFERRED COMPENSATION) LEAH MITCHELL $34,326 ($10,445 INCLUDED IN BONUS & INCENTIVE COMPENSATION AND $23,881 INCLUDED IN DEFERRED COMPENSATION) LORI JAMES-NEILSEN $24,142 (INCLUDED IN DEFERRED COMPENSATION) ANDREW FURMAN $24,174 (INCLUDED IN DEFERRED COMPENSATION) BAHAA WANLY $19,437 (INCLUDED IN DEFERRED COMPENSATION) DENISE HOOVER $11,418 (INCLUDED IN DEFERRED COMPENSATION) SHEA CORUM $2,558 (INCLUDED IN DEFERRED COMPENSATION) LEILANI SLAMA $3,681 (INCLUDED IN DEFERRED COMPENSATION) NORMAN GRUBER $2,122,873 (MULTIPLE YEARS OF NORMAN GRUBER'S ACCUMULATED 457(F)CONTRIBUTIONS VESTED UPON HIS RETIREMENT ON JULY 3, 2016 RESULTING IN $1,722,873 BEING REPORTED IN THE BONUS AND INCENTIVE COMPENSATION COLUMN, ADDITIONALLY $400,000 WAS INCLUDED IN DEFERRED COMPENSATION) JUAN OYARZUN $27,298 (INCLUDED IN DEFERRED COMPENSATION) NERVIN FANOUS $22,952 (INCLUDED IN DEFERRED COMPENSATION) NICOLE VANDERHEYDEN $60,352 ($31,022 INCLUDED IN BONUS & INCENTIVE COMPENSATION AND $29,330 INCLUDED IN DEFERRED COMPENSATION) JAMES SAPIENZA $17,713 ($15,762 INCLUDED IN BONUS & INCENTIVE COMPENSATION AND $1,951 INCLUDED IN DEFERRED COMPENSATION)
PART I, LINE 6CERTAIN PHYSICIANS RECEIVE INCENTIVE COMPENSATION IN ACCORDANCE WITH THEIR EMPLOYMENT AGREEMENTS WITH SALEM HEALTH. AMOUNTS NOTED ON SCHEDULE J PART II COLUMN (II) REFLECT PAYMENTS EARNED BY THESE PHYSICIAN EMPLOYEES IN SUCH AGREEMENTS. ADDITIONALLY, 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. JAMES SAPIENZA'S INCENTIVE PAYMENTS ARE BASED ON SALEM HEALTH WEST VALLEY'S BOARD APPROVED LEADERSHIP INCENTIVE PLAN. AMOUNTS NOTED ON SCHEDULE J PART II COLUMN (II) REFLECT PAYMENTS EARNED UNDER THE LEADERSHIP INCENTIVE PLAN.
PART I, LINE 7THE 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. IN THIS YEAR THE NON-FIXED PAYMENT WAS PAID UNDER THE 457(F) NONQUALIFIED PLAN AND IS INCLUDED IN DEFERRED COMPENSATION REPORTED IN PART II.
ADDITIONAL INFORMATION FOR EXECUTIVE TRANSITIONSNORMAN GRUBER, DURING THE 2016 CALENDAR YEAR UNTIL HIS RETIREMENT JULY 3, 2016, WAS A LOANED EXECUTIVE TO OHSU PARTNERS ACTING AS THE PRESIDENT OF OHSU PARTNERS. LORI JAMES-NIELSEN WAS CHIEF STRATEGY OFFICER UNTIL AUGUST 1, 2016. SUBSEQUENTLY SHE WAS A LOANED EXECUTIVE TO OHSU PARTNERS UNTIL MARCH 17, 2017.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
THE HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM OREGON REVENUE BONDS
A521542796794458CY32008-11-13$125,000,000REFUND SERIES 2004AB AND 2006B. PATIENT TOWER CONSTRUCTION AND OTHER IMP.000
THE HOSPITAL FACILITY AUTHORITY OF THE CITY OF SALEM OREGON REVENUE BONDS
B521542796794458EL92016-11-01$215,638,877REFUND SERIES 2013 AB AND 2008A. PAY COSTS OF ISSUANCE RELATING TO THE BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRefunding EscrowRefundingEscrowAmtUnspentUnspentAmt
A$50,000,000$125,021,764$633,004$1,153,492$9,260,268$113,975,0002009Yes (1)0Yes (1)Yes (1)
B$4,360,000$216,071,523$1,448,654$181,357,045Yes (1)Yes (1)Yes (1)Yes (1)$33,224,410$41,414

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndEngage Bond Counsel ResearchEngageBondCounselResearchIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)Yes (1)Yes (1)Yes (1)Yes (1)0.004000.001000.0050000Yes (1)
B0Yes (1)Yes (1)Yes (1)Yes (1)Yes (1)0.009000.002000.0110000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
UBS AG
A00Yes (1)Yes (1)Yes (1)Yes (1)25.8000000000000000Yes (1)
(no name)
B0Yes (1)Yes (1)00000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSUPPLEMENTAL INFORMATION:FormAndLineReferenceDesc
ExplanationCOLUMN A: DIFFERENCE BETWEEN PART I(E) AND PART II, LINE 3 IS DUE TO INTEREST EARNINGS IN THE PROJECT FUND. PART I (F): PROCEEDS WERE USED TO REFUND SERIES 2004AB AND SERIES 2006B BONDS, FINANCE THE CONTRUCTION OF THE PATIENT TOWER AND OTHER IMPROVEMENTS. PART II, LINE 1: BONDS REFUNDING SERIES 2008C: SERIES 2013AB (ISSUED JUNE 27, 2013). PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENTS TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III,LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2(B): THE REFUNDING AND NEW MONEY PORTIONS OF THE BONDS HAVE MET THE 6-MONTH EXCEPTION TO REBATE. PART IV, LINE 2(C): PROCEEDS OF THE BONDS MET A SPENDING EXCEPTION TO REBATE AND, THEREFORE, NO PAYMENT WILL EVER BE DUE ON THE BONDS. COLUMN B: DIFFERENCE BETWEEN PART I(E) AND PART II, LINE 3 IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS. PART I (F): BONDS PROCEEDS WERE EXPENDED TO REFUND THE 2013AB BONDS (ISSUED ON JUNE27,2013), TO REFUND THE 2008A BONDS (ISSUED ON OCTOBER 8, 2008) TO REFUND THE 2006A BONDS (ISSUED ON NOVEMBER 15, 2006) AND TO PAY COSTS OF ISSUANCE RELATING TO THE BONDS. PART II, LINE 13: SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART III, LINE 7:AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2(B): THE PORTION OF BOND PROCEEDS USED FOR CURRENT REFUNDING HAS MET THE 6-MONTH EXCEPTION TO REBATE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 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 12CON 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, TO BE COMPLETED A 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 15EXECUTIVE COMPENSATION AT SALEM HEALTH IS DESIGNED TO ALLOW THE ORGANIZATION TO RECRUIT AND RETAIN QUALIFIED SENIOR LEADERS. THE GOVERNANCE COMMITTEE OF THE SALEM HEALTH BOARD OF TRUSTEES, NONE OF WHOM IS A SALEM HEALTH EMPLOYEE, ENGAGES ONE OR MORE INDEPENDENT CONSULTANTS TO PROVIDE A 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 19THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE ON THE HOSPITAL WEBSITE.
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 5,954,044. CHANGE IN NET BENEFIT COST 1,220,707. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION -765,371. EQUITY TRANSFER BETWEEN RELATED ENTITIES -1,980,216.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MWVP INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1570 LIBERTY ST SE STE 200AddressLine1Txt
CitySALEMCityNm
State AbbreviationORStateAbbreviationCd
ZIP97301ZIPCd
FieldValueIRS element (for citing)
EIN123456789EIN
Primary ActivitiesHOLDS LANDPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SALEM HEALTH HOSPITALS AND CLINICSBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
SALEM HEALTH FOUNDATION
890 OAK STREET SESALEMOR97301237002687SUPPORTS SALEM HEALTHOR501(C)(3)7SALEM HEALTH HOSPITALS AND CLINICS0
SALEM HOSPITAL AUXILIARY
890 OAK STREET SESALEMOR97301931081113SUPPORTS SALEM HEALTHOR501(C)(3)90N/A
SALEM HEALTH HOSPITALS & CLINICS
890 OAK STREET SESALEMOR97301930823471LEASES LAND TO SALEM HEALTHOR501(C)(3)11 TYPE 10N/A
SALEM HEALTH WEST VALLEY
525 SOUTHEAST WASHINGTON STREETDALLASOR97338431960221HOSPITALOR501(C)(3)3SALEM HEALTH HOSPITALS AND CLINICS0
WEST VALLEY HOSPITAL FOUNDATION
525 SOUTHEAST WASHINGTON STREETDALLASOR97338931298564SUPPORTS SALEM HEALTH WEST VALLEYOR501(C)(3)11 TYPE 1SALEM HEALTH HOSPITALS AND CLINICS0
WILLAMETTE VALLEY INSURANCE COMPANY
745 FORT STREETHONOLULUHI96813201836190CAPTIVE INSURANCEHI501(C)(3)11 TYPE 1SALEM HEALTH HOSPITALS AND CLINICS0
SALEM HEALTH PROFESSIONAL SERVICES
890 OAK STREET SESALEMOR97301753175249BILLING SERVICE FOR PROFESSIONAL FEESOR501(C)(3)3SALEM HEALTH HOSPITALS AND CLINICS0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctUBI Code VUBICodeVAmt
OREGON COMMUNITY IMAGING LLC
2925 RYAN DR SESALEMOR97301202683062MEDICAL IMAGING COOPERATIVEORN/A
OHSU PARTNERS
3303 SW BOND AVE STE 6100PORTLANDOR97239475584608HEALTHCARE SYSTEM MANAGEMENTORN/A
POPULATION HEALTH ALLIANCE OF OREGON LLC
601 SW 2ND AVE STE 1940PORTLANDOR97204471546023POPULATION HEALTH DATA MANAGEMENTORN/ARELATED-$1,882,700$951,129000.23860
WILLAMETTE VALLEY COMMUNITY HEALTH LLC
2995 RYAN DRIVE SE STE 200SALEMOR97301455540852COORDINATED CARE ORGANIZATIONORN/ARELATED$488,963$1,008,771000.09090
PREMIER HEALTHCARE ALLIANCE LP
13034 BALLANTYNE CORPORATE PLACECHARLOTTENC28277330387407ENABLE HOSPITALS TO IMPROVE CLINICAL & FINANCIAL PERFORMANCENCN/ARELATED$1,144,182$1,625,5540Yes (1)0.00210$25,729
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd