2018-02-15T13:03:38-08:00 2017-03-31 990 2016-04-01 930591528 LEGACY MOUNT HOOD MEDICAL CENTER LEGA 5034155600 24800 SE STARK ST GRESHAM OR 97030 SARAH K JENSEN INTERIM CFO 2018-02-15 2016 2021-01-29 14:40:06Z GEORGE J BROWN MD C/O 1919 NW LOVEJOY STREET PORTLAND OR 97209 150550530 false false X WWW.LEGACYHEALTH.ORG X 1922 OR Legacy Mount Hood Medical Center (LMHMC) was founded in 1922 and is a community hospital in Gresham, OR. LMHMC offers a wide range of services including family birth, diagnostic services, cancer treatment, surgery and emergency services. 17 14 0 311 293035 -42903 39818 131950 151469194 148459719 -196248 1518944 0 151312764 150110613 10412 10412 0 66106460 69853231 0 0 74161739 73351492 140278611 143215135 11034153 6895478 104154630 109552243 54571752 51849084 49582878 57703159 Legacy Mount Hood Medical Center (LMHMC) was founded in 1922 and is a community hospital in Gresham, Oregon with 115 licensed beds. LMHMC offers a wide range of services including family birth, diagnostic services, cancer treatment, surgery and emergency services. LMHMC is part of Legacy Health (Legacy).Our mission:Our legacy is good health for our people, our patients, our communities, and our world. We will work as a team to demonstrate our values:Respect - Treat all people with respect and compassion Service - Put the needs of our patients and their families first Quality - Deliver outstanding clinical services within healing environments Excellence - Set high standards and achieve them Responsibility - Be good stewards of our resources, ensuring access to care for all Innovation - Be progressive in our thinking and actions Leadership - Serve as a role model of good health and good citizenship false false 108520644 10412 148459719 LMHMC provides inpatient and outpatient healthcare services to the communities it serves. In support of its mission, LMHMC voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. During fiscal year 2017, LMHMC provided financial assistance on approximately 13,630 patient accounts (of which 2,480 accounts received discounts totaling 100% of costs) and resulted in LMHMC incurring roughly $5,829,240 in uncompensated costs associated with this program. In addition to charity care, LMHMC provides services under various states' Medicaid programs for financially needy patients, Medicare beneficiaries and other government programs for which the cost of treating these patients exceeds the government payments received. During fiscal year 2017, LMHMC incurred approximately $13,665,160, $5,177,900 and $333,465 in uncompensated costs attributable to Medicaid, Medicare, and other government programs, respectively. LMHMC also provides a variety of other community benefit activities such as medical education, donations to other charitable entities, research, and other health improvement services which totaled roughly $1,006,850 during fiscal year 2017.LMHMC is part of Legacy, which collectively provided over $46 million, $199 million, $113 million, and $2 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2017. In addition, Legacy provided over $23 million in other community benefit activities during fiscal year 2017. 108520644 true true false true false false false false false true true true false false true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false false false false true true false false false true 0 0 false 0 false true true false false false false false false 0 false false false false false false false false false false X 17 14 false true false false true true true true true false false true true true true true true true true true true OR X X SARAH K JENSEN 5034155600 1919 NW LOVEJOY STREET PORTLAND OR 97209 BISHOP DAVID BRAUER-RIEKE BOARD DIRECTOR 4.00 0.00 X 0 0 0 JONATHAN HILL MD BOARD DIRECTOR 3.00 40.00 X 0 595264 34436 SHERYL MANNING BOARD DIRECTOR 4.00 0.00 X 0 37250 0 DAVID RAMUS BOARD DIRECTOR 3.00 0.00 X 0 17750 0 ROBERT L CORNIE BOARD DIRECTOR 3.00 0.00 X 0 32899 0 JEFFREY D FULLMAN MD Chairman 4.00 1.00 X X 0 79293 0 CORLISS A MCKEEVER BOARD DIRECTOR 3.00 0.00 X 0 10750 0 RT REV MICHAEL J HANLEY BOARD MEMBER 3.00 0.00 X 0 0 0 RONALD S KING VICE CHAIR 4.00 0.00 X X 0 49943 0 LESLIE ROOT MD BOARD DIRECTOR 4.00 1.00 X 0 20000 0 DIANE PINNEY BOARD DIRECTOR 4.00 0.00 X 0 21000 0 STEPHEN G NEWBERRY MD BOARD DIRECTOR 3.00 0.00 X 0 31994 0 JOHN W WINTER JR BOARD DIRECTOR 4.00 0.00 X 0 38500 0 GEORGE J BROWN MD President & CEO 0.00 40.00 X X 0 1601886 609328 ROBERT E DEWITT SR VP & SEC 0.00 40.00 X X 0 505269 42836 LINDA S HOFF CFO & TREASURER 0.00 40.00 X X 0 731073 279593 JEFFREY BARBER BOARD DIRECTOR 3.00 0.00 X 0 21117 0 JAMES WALKER BOARD DIRECTOR 3.00 0.00 X 0 20437 0 PATRICK REITEN BOARD DIRECTOR 3.00 0.00 X 0 21000 0 CHARLES WILHOITE BOARD DIRECTOR 3.00 0.00 X 0 16551 0 NANCY R LOCKE BOARD DIRECTOR 3.00 0.00 X 0 5250 0 GAYLE GOSCHIE BOARD DIRECTOR 3.00 0.00 X 0 5750 0 TRENT S GREEN SR VP 0.00 40.00 X 0 546117 239727 SONJA O STEVES SR VP 0.00 40.00 X 0 441126 102382 GRETCHEN M NICHOLS HOSPITAL PRESIDENT 40.00 0.00 X 381906 0 56079 EVERETT NEWCOMB III MD SR VP 0.00 40.00 X 0 1125666 337067 MAUREEN A BRADLEY SR VP 0.00 40.00 X 0 339181 51366 JOHN J KENAGY SR VP 0.00 40.00 X 0 522921 218485 LEWIS L LOW MD SR VP 0.00 40.00 X 0 639273 85365 CAROL A BRADLEY SR VP 0.00 40.00 X 0 469741 69793 AURA THERESA DE OLAZO MD MED DIR CLINIC 40.00 0.00 X 272023 0 41946 ARUNA JAYARAM MD PHYSICIAN 40.00 0.00 X 196210 0 26785 PHOEBE SHULMAN-EDLESON MD MED RAD PHYSICIST 40.00 0.00 X 201171 0 20946 LAURA OSTROM MD PHYSICIAN 40.00 0.00 X 241012 0 31315 STEPHEN SLATTERY MD PHYSICIAN 40.00 0.00 X 222531 0 25472 1514853 7947001 2272921 114 false true false MCKINSTRY CO 16790 NE MASON ST 100 PORTLAND OR 97230 CONTRACT SERVICES 219363 OREGON ANESTHESIOLOGY GROUP PC 120 NW 14TH AVE 300 PORTLAND OR 97209 MEDICAL SERVICES 322695 ZIMMER GUNSUL FRANSCA ARCHITECTS LLP 1223 SW WASHINGTON ST 200 PORTLAND OR 97205 CONSTRUCTION 491587 NW CARDIOVASCULAR INSTITUTE 2222 NW Lovejoy st 606 PORTLAND OR 97209 MEDICAL SERVICES 364543 ECHO VISION INC 7214 NE 72ND PL VANCOUVER WA 98662 MEDICAL SERVICES 288210 9 131950 131950 CAFE, PHARMACY & ETC 714296 714296 CHARITY CARE -18832947 -18832947 CONTRACTUAL ALLOWANCE -272640329 -272640329 PATIENT PROGRAM REV 438925664 438925664 PHARMACY 293035 293035 148459719 1936861 1936861 0 0 0 22000 439917 -417917 -417917 -417917 0 0 0 0 150110613 147452388 293035 2233240 10412 10412 0 0 0 437985 390770 47215 0 56170173 50468635 5701538 1765102 1581298 183804 7001878 6282136 719742 4478093 4016984 461109 0 20856 20856 0 0 0 0 2157974 2157974 0 20573888 19655932 917956 0 0 949755 739397 210358 75423 58718 16705 0 0 1101375 857435 243940 0 7085810 5516397 1569413 1099123 987987 111136 ADMINISTRATIVE SERVICES FEES 23182389 23182389 CONTRACT SERVICES 9268370 8624884 643486 PROVIDER TAX 7606781 7606781 CONSULTING 452620 452620 -222872 -435096 212224 143215135 108520644 34694491 0 136025 174353 0 0 19289216 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LIABILITY 331214 42411586 150610000 384921 384921 150225079 -114466 -114466 150110613 143748000 384921 384921 143363079 -147944 -147944 143215135 Part V, Line 4: Intended uses of the endowment fund. Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Mount Hood Medical Center Foundation (MHMCF) maintains all charitable gifts including endowment funds for the benefit of LMHMC and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator. Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 PROGRAM SERVICE REVENUE RECLASS $384921 Part XII, Line 2d: Other expenses and losses per audited F/S PROGRAM SERVICE REVENUE RECLASS $384921 true true X true X 300.000000000 true X true true true false true true 5829239 5829239 0.04070 42145675 28480513 13665162 0.09540 1759503 1426038 333465 0.00230 49734417 29906551 19827866 0.13840 31638 31638 0.00020 716295 716295 0.00500 258921 258921 0.00180 1006854 1006854 0.00700 50741271 29906551 20834720 0.14540 false 22008742 24413757 -2405015 X true true 1 1 LEGACY MT HOOD MEDICAL CENTER 24800 SE STARK STREET GRESHAM OR 97030 www.legacyhealth.org 14-1337 X X X LEGACY MT HOOD MEDICAL CENTER 1 false false true X X X X X X X X X 14 true true true true X www.legacyhealth.org true 14 true www.legacyhealth.org false false true X 300.0000 400.0000 X X X X X true true X X X true X www.legacyhealth.org X www.legacyhealth.org X www.legacyhealth.org X X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community In 2014, Legacy Mount Hood Medical Center participated with the 14 other hospitals, four public health departments and two Coordinated Care Organizations in the metro four county area regional Healthy Columbia Willamette Collaborative Community Health Needs Assessment (CHNA) which was used as a base for the Legacy Mount Hood Community Health Needs Assessment. The results of Legacy's community needs assessment can be found at www.legacyhealth.org.The 2014 Community Needs Assessment is conducted based on the Healthy Columbia Willamette Collaborative (HCWC) Community Health Needs Assessment (CHNA). The HCWC CHNA is regional and developed to improve efficiency and effectiveness and also to help meet the requirements of the ACA and Public Health Accreditation. The regional CHNA obtained information from the community through a variety of venuessurveys and interviews with public health, tribal, regional, state or local health or other departments as well as medically underserved, low income and minority populations and those with chronic disease needs; a review of community engagement/needs assessment projects; and community listening sessions with uninsured and/or low-income community members from diverse culturally-identified and geographic communities. The following organizations were surveyed or interviewed.Adelante Mujeres Adult Mental Health and Substance Abuse Advisory Council Allies for a Healthier Oregon Ant Farm Calvary Church Central City Concern Clackamas County Public Health Advisory Committee Clackamas Service Center Coalition of Community Health Clinics Elders in Action Commission El Programa Hispano FamilyCare Community Advisory Council Free Clinic of SW Washington Hacienda CDC Health Share of Oregon Community Advisory Council Highland Church & Highland Access, Reentry and Recovery Program Immigrant and Refugee Community Organization The Intertwine Alliance Latino Network Liberation Street Church Lifeline Connections LifeWorks Northwest Multnomah County Health Equity Initiative Native American Youth Association National Alliance on Mental Illness (Clackamas) OHSU Richmond Clinic Health Literacy Committee Oregon Community Health Worker Association Oregon Health Equity Alliance Outside In Oregon Foundation for Reproductive Health Oregon Public Health Institute Project Access NOW Q Center Urban League of Portland Veterans Affairs Hospital Washington County Mental Health and Addictions Advisory Council Washington County Public Health Advisory Council Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment In addition to Legacy Mount Hood Medical Center, the HCWC comprised of 14 other hospitals in the metro area and are as follows : Adventist Medical Center, Kaiser Permanente Sunnyside Medical Center, Kaiser Permanente Westside Medical Center, Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center, Legacy Salmon Creek Medical Center, Oregon Health & Science University, Peace Health Southwest Medical Center, Providence Milwaukie Medical Center, Providence Portland Medical Center, Providence St. Vincent Medical Center, Providence Willamette Falls Medical Center and Tuality Health Care/Tuality Community Hospital. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Legacy Mount Hood did not address needs identified in the Community Needs Assessment for the reasons explained in the following, by need. These are included in the Community Needs Assessment and Implementation Strategies Plan.NEED: Mental Health: Limited financial and labor resources prevent addressing as need.NEED: Addiction/Substance Abuse: Limited financial and labor resources prevent addressing as need.NEED: Public Health: Limited financial and labor resources prevent addressing as need.NEED: Dental: Limited financial and labor resources prevent addressing as need.NEED: Childhood Obesity and Physical Activity: Limited financial and labor resources prevent addressing as need.NEED: Natural Environment: Limited financial and labor resources prevent addressing as need.NEED: Early Childhood: Limited financial and labor resources prevent addressing as need.NEED: HIV/AIDS: Limited financial and labor resources prevent addressing as need.NEED: Transgender Care: Limited financial and labor resources prevent addressing as need.NEED: Autism: Limited financial and labor resources prevent addressing as need. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense LMHMC uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, LMHMC must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The estimated amount of bad debt expenses attributable to charity care policy was calculated using the demographic profile of household income and average household size in the zip code areas around the hospital. 61% of Households in the LMHMC service area would qualify for financial assistance with incomes under 400% of the Federal Poverty Guidelines under this methodology. Part III, Line 4 - Bad Debt Expense The footnote that describes the Legacy bad debt expense can be found on Page 11 of the attached audited financial statements. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $52,688,420 and $57,866,320 respectively. This results in a total Medicare shortfall of $5,177,900.Costing Methodology (Part III, Line 8).Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Legacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues. Part VI - Needs Assessment The described CHNA provides the primary source for assessing needs. Senior leadership, in conjunction with the Board of Directors, continually assesses the needs of the communities it serves through a compilation of primary and secondary market research (qualitative and quantitative), medical staff input, reviewing national trends and practices, working with local foundations and funders regarding their assessments, and working with local community-based partners to understand their needs. The goal is to understand the needs and develop programs specific to the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of these assessments is the development of both long-term and fiscal year plans that are supported by a yearly budget that is proposed by staff and approved by the Board of Directors. Community Benefit and Community Relations staff as well as Legacy representatives on nonprofit and community based boards serving communities at risk also provide ongoing informal feedback regarding needs. These are then aligned to the community health needs identified in the formal CHNA. The region served by Legacy Mount Hood Medical Center (LMHMC), along with most of Oregon, is experiencing significant challenges in population growth, economic development, education and health care. Recognizing that social and economic determinants impact health, LMHMC has been and will remain committed to addressing these issues to improve the health of all residents in the community, including equity among ethnically diverse populations. Part VI - Patient Education of Eligibility for Assistance LMHMC employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, LMHMC's financial assistance program, and public assistance programs, such as Medicaid. The criteria for financial assistance under LMHMC's program is determined based on eligibility for insurance coverage, household income, qualified assets, catastrophic medical events, or other information supporting a patient's inability to pay for medically necessary services provided. Specifically, the LMHMC Financial Assistance Program provides an uninsured discount of 35% to patients who have resided within LMHMC's primary service area for a period of six months, are uninsured for hospital care, and have a household income of less than $100,000 annually. Further discounts are available for patients, on a sliding scale, whose household income is less than 400% of the federal poverty level or roughly $97,000 for a family of four in Portland, Oregon. For patients whose household income is at or below 300% of the federal poverty level, a full subsidy is available. In addition to the household income criteria, the patients' qualified assets (e.g. 25% of household assets), and other catastrophic or economic circumstances are considered in determining eligibility. In addition to financial counselors and social workers, LMHMC makes every effort to communicate its Financial Assistance Program to all patients. This includes signage in main admitting areas of each hospital and brochures explaining financial assistance in all patient care areas, as well as in appropriate languages. Financial counselors are available to assist patients in understanding and applying for available resources, including the LMHMC Financial Assistance Program. LMHMC's website also has information about the availability of financial assistance. LMHMC offers financial assistance customer service Monday through Friday, as well as the availability of voice mail so patients can leave confidential, detailed messages during non-business hours. Finally all of Legacy's billing statements include information regarding the availability of financial assistance. If LMHMC requires the use of a collection agency, those agencies are required to provide a telephone number that patients can call to request financial assistance.In 2010, Legacy Health established the Health Literacy initiative. Nearly all Legacy employees are touch points to patients and families and health literacy is involved in every touch pointWhat is health literacy? The Institute of Medicine defines health literacy as the capacity to obtain, understand, and process basic health information and services needed to make appropriate health decisions. In short, health literacy is the ability to understand and act on health information. Nearly half of the U.S. adult population has a low level of health literacy. Patients with low health literacy are less likely to comply with treatment, less likely to seek preventive care and twice as likely to be hospitalized. Quality, safety and cost are all affected by a patient's inability to understand medical instructions and to explain their symptoms/issues. Legacy's employees are learning and practicing new way of communicating with patients using health literacy tools such as universal precautions, plain language and teach back methods.Annual education is provided to all billing and admitting staff so they can be kept informed of and speak with knowledge about current financial assistance policies and options. LMHMC provides copies of the latest policies in main admitting areas, as well as through newsletters and other publications. Since 2008, the four county metro area health delivery systems (encompassing all hospitals in the area) and safety net clinics have partnered to establish a seamless, coordinated program to provide care for the low income uninsured, Project Access. This program enables low income uninsured patients to receive continuity of care in earlier stages of acuity due to the collaboration among 2800 providers and all health systems. Part VI - Community Information LMHMC is located in Gresham, a suburban area about 25 miles east of downtown Portland. The total service area extends from the Columbia River in the north to Estacada in the south and from 122nd Avenue in the west to Mt. Hood in the east. The five mile primary service area includes the cities/towns of Gresham, Troutdale, Fairview, Corbett and Wood Village. Zip codes for the primary service area include: 97009, 97019, 97024, 97030, 97055, 97060, 97080, 97230, 97233 and 97236. While Gresham is the fourth largest city in Oregon, the other communities are much smaller in population. The communities are contiguous to each other. People living in this area perceive themselves as distinct from Portland, Oregon, although the majority works in Portland. The towns have strong local governments and identities.The primary service area is situated in the eastern third of the same county as the larger urban core--Portland (referred to as East Multnomah County). This presents challenges as the urban center/county seat consumes the majority of dollars and services and East Multnomah County often feels ignored. The situation is especially pressing as demographics are shifting such that East Multnomah County requires additional services and dollars, but struggles to be heard relative to Portland. The area is working diligently to have a stronger employment base which is critical for schools, public sector services and autonomy within the county.The population of the five mile primary service area was 115,365 in 2013. Annual growth from 2013 to 2018 is projected to be 5.85%. East Multnomah County is expected to grow at a higher rate than West Multnomah County. The majority lives in Multnomah County which showed a 2013 estimated population of 766,135. Multnomah County contains 35.5 percent of the four county population and 19.5 percent of the Oregon 2013 3,930,065 residents. In 2013 the LMHMC primary service area was 73.6 percent non-Hispanic white, 15.7 percent Hispanic, 2.1 percent African American, 4.4 percent Asian and Pacific Islander, 3.6 percent bi-racial, .1 percent other race and .7 percent Native American. As home and rental costs in the City of Portland have increased significantly in the past decade, communities of color have sought housing in the surrounding communities. The African American/Black population continues to be most concentrated in the historical neighborhoods of North/Northeast Portland, but increased housing prices have resulted in the community moving increasingly to East Multnomah County.Hispanics are moving into the LMHMC service area at a higher rate than any other group (more than doubling in numbers in the past 15 years). Additionally, they have a higher birth rate than other communities of color. The Hispanic population accounts for about one-fifth of the births in Oregon, while they make up just one-tenth of the population. A number of the elementary schools in East County are 50 percent Hispanic.The Slavic community, in addition to the Hispanic community, has settled in the area. While still a small population relative to the entire metro area, specific geographic areas are experiencing significant growth in the Slavic population, particularly in the southern East Multnomah County. Slavs are counted in the non-Hispanic white population, but they have distinct cultural identity. Their socioeconomic indicators are generally lower than the other non-Hispanic white population.The immigrant and refugee population is growing significantly in the region. Recent immigrants and refugees are more likely to be culturally and linguistically isolated. Speaking a language other than English at home has increased significantly, particularly in East County and specific neighborhoods such as Rockwood which is located on the edge of west Gresham. Spanish is the most common language spoken followed by Slavic languages.From 2008 -2012, Multnomah County had a median household income (mhi) of $51,582 with 17.1 percent of the population living below poverty. In Multnomah County, non-Hispanic white median household income was at $55,346, while Black/African Americans had the lowest MHI of $27,347 followed by American Indian/Alaska Native at $29,695 and Hispanic/Latino at $36,572. In contrast, Asians MHI was $54,561. Families living below poverty level show non-Hispanic white at 7.9 percent relative to Asian at 12.6 percent, two or more races at 19.6 percent, Black/African American at 32.6 percent, Hispanic/Latino at 30.7 percent and American Indian/Alaska Native at 35.5 percent. The Dignity Health and Truven Health Community Needs Index (CNI) is accepted as the national standard in identifying communities with health disparities and comparing relative need. A higher score indicated a greater need. The location of one of the four highest self-pay zip codes in close proximity to Legacy Mount Hood which is 97233-Rockwood. Legacy Mount Hoods focus is the highest Community Needs Index zip codes in its area which include: 97233-Rockwood, 97024-Fairview, 97030-Central Gresham, 97236-Powell Butte.The LMHMC is the sole hospital in the primary service area. Three other health systems have a strong clinic presence.With the long-standing income disparities and increase in diversity in the LMHMC area, safety net services have expanded and emerged. Multnomah County Health Department operates FQHCs in inner Gresham and Rockwood, a neighborhood on the western edge of Gresham (the site of one of the highest Community Needs Index scores in the entire metro area). The Wallace Medical Concern, formerly a volunteer staff safety net clinic, obtained FQHC status and is now housed in Rockwood. A physician staffed safety net clinic is also in Gresham. One-fourth of the census tracts in Rockwood have Medically Underserved Population designation with an uninsured population of 30%. Two safety net clinics serve the area. One is a physician staffed nonprofit in Gresham. The other in Rockwood is Wallace Medical Concern a volunteer staffed clinic which receives Legacy's financial support, donated laboratory services and board representation. Wallace recently moved into a permanent expanded space and is seeking FQHC look-alike status and projects serving 5900 patients annually within the second year of the move. Legacy Medical Group Clinic in Sandy is 13 miles from the hospital and is a designated Rural Health Center.A local non-profit, Project Access NOW, links uninsured low income individuals to no-cost healthcare services. All of the health systems in the metro area are very involved with this program. Legacy Health provides cash donations as well as clinical services.The Affordable Care Act is significantly increasing the insured rate in Oregon. With a June 2013 Oregon uninsured rate of 14 percent, by June 2014 the rate had decreased to 5.1 percenta 63 percent decrease (from 550,000 to 202,000 people). Most of the newly enrolled are now in the Oregon Health Plan which increased 360,000 people--59 percent.In FY 17, LMHMC provided $5.8 million in charity care and $19.8 million in total unpaid costs of care for those in need. LMHMC has historically been among the highest charity care provider as percent of charges among all metro area hospitals. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Non-cash donations of resources include clinical and non-clinical services and items, e.g., screenings and support services, internships, information and referral services and health fairs. Legacy's warehouse located in NW Portland is open to nonprofit organizations to obtain surplus equipment and furniture. In addition, conference room space is made available to local nonprofits for Board and community meetings.Clinical staff is involved with local communities through many child safety programs. In 1986, nurses in Legacy Emanuels Level I Trauma Center developed the Trauma Nurses Talk Tough (TNTT) program. The American Hospital Association awarded the TNTT program its NOVA Award. In addition, Legacy staff members conduct free checks to show parents how to properly install car seats. Last year, Legacy staff fit and sold more than 8,000 bicycle helmets to children at a nominal or no fee based on need. Legacy staff members also provide new parents with training to reduce the incidences of shaken baby syndrome and a Safety Store sells child protection devices for the home at nominal charge. Part VI - Affilated Health Care System Roles and Promotion LMHMC is a subsidiary of Legacy Health (Legacy). Legacy is an integrated health system based in Portland, Oregon and primarily operates six acute care hospitals and related services (e.g., physician practices, hospice, preferred provider network) in the four county metro area of Portland and SW Washington. The Legacy Board is comprised of community and business leaders as well as representatives of the medical staff. The LMHMC medical staff is open, with physicians submitting credentialing information reviewed according to LMHMC policies and standards. In 1998, the Legacy Health Board approved a $10 million Community Health Fund from operating revenue to address major community health issues. For more than a decade, about $500,000 has been granted annually to community-based projects addressing racial and ethnic inequities and root causes. These dollars are in addition to the systems generous charitable contributions. The Community Health Fund has provided 50 grants since 1998 totaling over $8.1 million. An example is the three-year, $175,732 partnership among local organizations dedicated to increasing the health literacy of patients, clients and residents of the neighborhood, many of whom are Latino and the very poorest in the four county metropolitan area. Legacy Health is now the recognized leader in moving health literacy forward both in the health delivery system and broader community.Recognizing that education, employment and income inequities exist for communities of diversity, and that health professions are lacking in diversity, Legacy established the Youth Employment in Summer program in 1999. Fifteen African American, Hispanic and Native American youth receive paid summer employment in departments where they work with health professionals and college scholarships between $3,000 and $6,000 annually. Students remain in the program as long as they remain in school and pursued health careers. Some students remain in the program as long as seven yearsgraduating with imaging tech degrees, bachelor degrees in nursing, etc. The vast majority of the students are the first in their families to go to college. In addition to the Community Health Fund, Legacy provided cash donations to local health and human service, education, economic development and civic organizations. Donations focus on organizations with year-round relationships through programs and board representationspecifically focused organizations addressing disparities. A few examples include the Boys and Girls Club, Mt. Hood Community College Foundation, Gresham Barlow School District and Human Solutions. In addition, Legacy is a strong partner with The Wallace Medical Concern, a local safety net clinic serving a significant majority of Latinos.In 2010, Legacy Health established the Health Literacy initiative. Communication with patients such that patients both understand AND can act on the information required of and provided to them is critical to their health outcomes. Patients must use information to navigate the health system (complete insurance and government forms, sign consents, schedule appointments), manage diseases and acquire preventive screenings. Providers (defined as all staff interacting with or developing materials used by patients) are responsible for ensuring that patients can act on the information provided. Funded by the Community Health Fund in 2012, Legacy hosted the first Oregon and SW Washington Health Literacy Conference. 360 people from 69 organizations attended. Since 2012, the Health Literacy Conference has been organized every year with more than 500 health professionals attending each year from 80 organizations. Part VI - States Where Community Benefit Report Filed OR false MEDICAL TEAMS INTERNATIONAL 14150 SW MILTON CT TIGARD OR 97224 930878944 0 10412 COST SUPPLIES FOR DISASTER ASSISTANCE 1 0 false true false true true true true false true true ARUNA JAYARAM MD PHYSICIAN 180003 16715 -508 16869 9916 222995 AURA THERESA DE OLAZO MD MED DIR CLINIC 200129 70515 1379 14884 27062 313969 CAROL A BRADLEY SR VP 363719 100645 5377 40287 29506 539534 EVERETT NEWCOMB III MD SR VP 642989 211041 271636 303743 33324 1462733 262521 GEORGE J BROWN MD President & CEO 1060375 402174 139337 554496 54832 2211214 116315 GRETCHEN M NICHOLS HOSPITAL PRESIDENT 302694 80486 -1274 33983 22096 437985 JOHN J KENAGY SR VP 397730 109931 15260 186928 31557 741406 JONATHAN HILL MD BOARD DIRECTOR 495206 75794 24264 10880 23556 629700 LAURA OSTROM MD PHYSICIAN 201650 33886 5476 15310 16005 272327 LEWIS L LOW MD SR VP 495694 137164 6415 54233 31132 724638 LINDA S HOFF CFO & TREASURER 552657 181393 -2977 253924 25669 1010666 MAUREEN A BRADLEY SR VP 255549 82897 735 27589 23777 390547 PHOEBE SHULMAN-EDLESON MD MED RAD PHYSICIST 200072 833 266 12737 8209 222117 ROBERT E DEWITT SR VP & SEC 390062 107326 7881 28622 14214 548105 SONJA O STEVES SR VP 346728 95943 -1545 80138 22244 543508 STEPHEN SLATTERY MD PHYSICIAN 179539 39824 3168 13148 12324 248003 TRENT S GREEN SR VP 431959 118187 -4029 206962 32765 785844 Part I, Line 5b: Explanation of organization compensation based on revenues of related organization Physicians employed by Legacy affiliates are paid a bonus contingent upon their revenue generated during the year measured by industry standard relative value units (RVU). Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or Legacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets. Part I, Line 8: Amounts reported on 990 VII pursuant to initial contract exemption described in Regs Legacy enters into initial employment agreements with executives that qualify under the initial contract exception. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee relies on comparable market data and all decisions are documented. Part III, Additional Information Sch J, Part 1, Question 3 Regarding Compensation PracticesDirectors for Legacy started receiving compensation for their services in August 2014. They also receive expense reimbursements related to their duties. Any expense reimbursements to board members are reviewed by the Director of Tax for determining 1099 tax reporting. In addition to the Board of Directors compensation, during 2016, Dr. Hill received compensation related to his duties as Medical Director while Dr. Fullman received compensation for medical services provided to Legacy Meridian Park Hospital. There was no other reportable compensation received by any board member during 2016.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market.The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for executive positions. The Committee oversees the system's governance procedures with respect to intermediate sanctions legislation and the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Sch J, Part II, Column Breakdown Of W-2 Or Misc-1099:Column B(i) - Base compensation consists of regular base pay including employee elected deferrals for retirement plans (403(b) and 457(b) plans).Column B(ii) - The incentive compensation program for Legacy is based on predetermined criteria and reviewed and approved by the Board. Bonuses are paid to key employees for interim duties outside their primary responsibilities (e.g. Acting in Capacity).Column B(iii) - Other compensation consists of deferred compensation amounts paid to executives during the current year and were reported on prior form 990 returns.These amounts include arrangements that contain elements of a substantial risk of forfeiture conditioned on continued employment, vesting and/or a noncompete provision upon termination of employment. Distributions from 457(b) plans, reported to the employee on a 1099-R, are also included as other compensation. In addition, imputed income for insurance, cell phone and other benefits is included in other compensation as well as any severance related payments.Column C - Deferred compensation includes the value of defined benefit plans, contributions to defined contribution plans, amounts deferred under the 457(f) plan including earnings, earnings in the 457(b) plan, and the value of the pension restoration plan. Earnings on the 457(f) and 457(b) include gains and losses on the underlying investments.The defined contribution plan is available to all employees as they become qualified to participate. The pension restoration plan provides executive pension benefits in excess of IRS mandated limits on eligible compensation to key executives. The benefits are unfunded and subject to forfeiture. Executive pension benefits are intended to make the executive's retirement benefit, as a proportion of their final average salary, comparable to all other employees, and are treated as income when paid.The Legacy Health Board approved the goals and long-term objectives for the Executive Long Term Incentive Plan effective April 1, 2014 for 3 years ending on March 31, 2017. The plan was discretionary and could be terminated at any time. The purpose of the Plan was to attract and retain highly qualified senior executives, to focus management performance and reward participants for contributing to the accomplishments of Legacys long-term objectives. The longterm strategic goals included the development of a health plan partnership strategy; partner withother local healthcare providers to open a center for behavioral health; expanded use of information technology and data analytics to improve patient care; and executing an urgent care strategy to improve access to care and reduce emergency visits. Targets for operating margins and clinical quality were required over the three year period and all goals were measured at March 31, 2017. The Plan was funded and paid out in May 2017 after approval from the Legacy Health Compensation committee and the Legacy Health Board. A portion of the pay out was reported as deferred compensation on the FY2016 990. The balance amount will be reported asdeferred compensation for FY2017.Column D - Nontaxable benefits include company paid health and welfare and long term care and disability benefits under group plans.Column F - Current year compensation reported as deferred in prior years. Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company Legacy Health (Legacy) provides management services for all of its affiliated companies which includes, accounting, purchasing, contracting, legal, human resources, information technology, billing, facilities, budgeting, transcription, security, public relations, strategic planning, organization development. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Legacy Health is the sole member of Legacy Mount Hood Medical Center. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors includes the following members: (a) The Bishop of the Oregon Synod of the Evangelical Lutheran Church inAmerica (the "Oregon Synod") or the Bishop's designee, who shall serve ex officio;(b) The Bishop of the Episcopal Diocese of Oregon (the "Episcopal Diocese")or the Bishop's designee, who shall serve ex officio;(c) One (1) person appointed by election of the Oregon Synod Council;(d) One (1) person appointed by election of the Convention of the EpiscopalDiocese. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The appointed persons by the Oregon Synod Council and the Convention of the Episcopal Diocese may not be removed from the Board without written consent of their respective organizations. Form 990, Part VI, Line 11b: Form 990 Review Process The Legacy Board received a copy of the 990 return prior to filing. At the direction of the entire Board, the Board Compensation Committee reviewed the compensation disclosures and the Board Audit Committee reviewed the 990 returns for Legacy and Legacy Emanuel Hospital & Health Center with Management prior to filing. Any key differences in disclosure for other affiliated entities, including Legacy Mount Hood Medical Center were discussed with the Board Audit Committee. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The following is a summary of Legacy's policy and procedures for conflict of interest disclosure, monitoring and resolution.All Legacy employees and non-employees in leadership positions (e.g., Board members, Foundation Trustees, Medical Directors) are required to disclose potential conflicts of interest as the conflict arises. All employees are required to disclose any conflict of interest per the Standard of Conduct policy. Certain groups have annual formal disclosure requirements, Executives and non-employees in leadership positions complete the Conflict Disclosure Statement from the Standards of Conduct policy annually. Officers, Directors, Trustees, Key and Highly Compensated employees are also required to complete a questionnaire covering business relationships, business transactions with interested parties, loans and grants. Conflict Disclosure Statements and questionnaires are returned to Legacy Corporate Compliance or Tax Departments for review of the disclosure. If a conflict is disclosed, or identified through any other means, Legacy Corporate Compliance ensures that management mitigates the risk (e.g., discontinues relationship with vendor, segregates responsibilities, recuses Board member from voting in area of conflict) and that the conflict and mitigation steps are reported to the appropriate level (e.g., Compliance Committee, Audit Committee of the Board). Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The following describes the compensation practices of Legacy and its affiliates.Executive compensation for Legacy is designed to recruit, retain and motivate qualified senior management personnel. The comprehensive compensation plan is designed for positions that have a significant impact on the high-level strategic and policy direction of Legacy and its affiliates.Base pay and total compensation (including incentive compensation) for similar positions is established at a level comparable to market compensation for healthcare organizations. External consultants are regularly used to review published compensation surveys of comparable organizations and comparable benchmark positions in the market. The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for key executive positions. The Committee oversees the system's governance procedures with respect to the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Legacy Health's audited and interim consolidated financial statements are publicly available on the Electronic Municipal Market Access(EMMA) (www.emma.msrb.org) and DAC Bond (www.dacbond.com) websites. Legacy's audited consolidated financial statements include consolidating schedules which highlights LMHMC's financial results.When changes are made to the LMHMC Articles or Bylaws, LMHMC discloses and attaches copies to the IRS Form 990, which are publicly available by request or on various public websites such as Guidestar(www.guidestar.org). Other governing documents are not available to the public. Other Changes In Net Assets Or Fund Balances - Other Increases CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY = $1240229 Other Changes In Net Assets Or Fund Balances - Other Decreases GIFT SHOP OPERATIONS FUND = -$15430 Other Changes In Net Assets Or Fund Balances - Other Increases Rounding = $4 Form 990, Part IV, question 12 Legacy has an audit of its consolidated financial statement which includes consolidating schedules highlighting LMHMC's financial results. Form 990, Part VI, question 2 Legacy Health System CPC, LLC (CPC) is a common pay agent for Legacy and its affiliates. The CPC files all required federal employment tax returns for Legacy and its affiliates. The number of employees reported on Form W-3 for LMHMC is 978. Form 990, Part X LMHMC participates in the Legacy investment pooled funds which include professionally managed equity and fixed income securities in both separately managed portfolios and commingled investment accounts. Investment returns are prorated according to each affiliate's share of the pool. Form 990, Schedule J Schedule J Reporting of Officers and Senior Management on Legacy Affilate Returns. The Legacy Officers, Senior Vice Presidents and other key employees may have responsibilities for the operations of the entire health system, including the affiliated entities. Their compensation is paid from and reported on the Legacy return(EIN 23-7426300). The compensation is reported again for informational purposes on related affiliated entity returns including, Legacy Emanuel Hospital & Health Center, Legacy Good Samaritan Hospital and Medical Center, Legacy Meridian Park Hospital, Legacy Mount Hood Medical Center, Legacy Salmon Creek Hospital, Legacy Visiting Nurse Association, and Legacy Adventist Venture. LEGACY HEALTH 1919 NW LOVEJOY ST PORTLAND OR 97209 237426300 HEALTHCARE OR 501(C)(3) 11b N/A false LEGACY EMANUEL HOSPITAL & HEALTH CENTER 2801 N GANTENBEIN AVE PORTLAND OR 97227 930386823 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY GOOD SAMARITAN HOSPITAL & MEDICAL 1015 NW 22ND AVE PORTLAND OR 97210 930386793 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY MERIDIAN PARK HOSPITAL 19300 SW 65TH AVE TUALATIN OR 97062 930618975 HOSPITAL OR 501(C)(3) 3 N/A false LEGACY SALMON CREEK HOSPITAL 2211 NE 139TH ST VANCOUVER WA 98686 331065485 HOSPITAL WA 501(C)(3) 3 N/A false LEGACY VISITING NURSE ASSOCIATION 815 NE DAVIS ST PORTLAND OR 97210 930848530 HOSPICE OR 501(C)(3) 9 N/A false MT HOOD MEDICAL CENTER FOUNDATION PO BOX 4484 PORTLAND OR 97208 930794951 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A true EMANUEL MEDICAL CENTER FOUNDATION PO BOX 4484 PORTLAND OR 97208 936095667 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false RANDALL CHILDRENS HOSPITAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 931314469 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false GOOD SAMARITAN FOUNDATION PO BOX 4484 PORTLAND OR 97208 237017276 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false MERIDIAN PARK MEDICAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 930773410 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false SALMON CREEK HOSPITAL FOUNDATION PO BOX 4484 PORTLAND OR 97208 830433165 CHARITABLE FOUNDATION WA 501(C)(3) 7 N/A false LEGACY ADVENTIST VENTURE 1919 NW LOVEJOY ST PORTLAND OR 97209 931121816 HEALTHCARE OR 501(C)(3) 9 N/A false LEGACY HEALTH FOUNDATION 1919 NW LOVEJOY ST PORTLAND OR 97209 465562403 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false SILVERTON HEALTH 342 FAIRVIEW STREET SILVERTON OR 97381 930281321 HOSPITAL OR 501(C)(3) 3 N/A false SILVERTON HEALTH FOUNDATION 342 FAIRVIEW STREET SILVERTON OR 97381 930913392 CHARITABLE FOUNDATION OR 501(C)(3) 7 N/A false MANAGED HEALTHCARE NORTHWEST 1919 NW LOVEJOY ST PORTLAND OR 97209 930914759 MEDICAL OR LEGACY MT HOOD MEDICAL CENTER C 100507 528170 0.75000 true false true true false false false false true true true true false true true false false false false false MT HOOD MEDICAL CENTER FOUNDATION c 53649 Cash MT HOOD MEDICAL CENTER FOUNDATION m 153027 Actual Cost