STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

GOOD SHEPHERD HEALTH CARE SYSTEM: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
GOOD SHEPHERD HEALTH CARE SYSTEM (EIN 93-0425580)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-14
IRS object ID
201541349349300619
Schema version
2013v4.0
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)
Return2015-05-14T07:02:00-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930425580EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Good Shepherd Health Care SystemBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlGOODBusinessNameControlTxt
Phone5416673400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11th StreetAddressLine1
CityHermistonCity
StateORState
ZIP Code97838ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDennis BurkePersonNm
Person TitlePresident/CEOPersonTitleTxt
Phone5416673400PhoneNum
Signature2015-05-05SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2015-05-05PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Good Shepherd Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Principal OfficerDennis BurkePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11th StreetAddressLine1
CityHermistonCity
StateORState
ZIP Code97838ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$139,526,107GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.gshealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1953FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionHospital and health care services.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee639TotalEmployeeCnt
Total Volunteers136TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$308,309PYContributionsGrantsAmt
CY Contributions Grants$125,663CYContributionsGrantsAmt
PY Program Service Revenue$78,776,801PYProgramServiceRevenueAmt
CY Program Service Revenue$83,761,041CYProgramServiceRevenueAmt
PY Investment Income$4,138,296PYInvestmentIncomeAmt
CY Investment Income$4,321,534CYInvestmentIncomeAmt
PY Other Revenue$128,348PYOtherRevenueAmt
CY Other Revenue$119,592CYOtherRevenueAmt
PY Total Revenue$83,351,754PYTotalRevenueAmt
CY Total Revenue$88,327,830CYTotalRevenueAmt
PY Grants And Similar Paid$326,745PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$313,800CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$38,275,999PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,975,186CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$32,409,194PYOtherExpensesAmt
CY Other Expenses$32,244,427CYOtherExpensesAmt
PY Total Expenses$71,011,938PYTotalExpensesAmt
CY Total Expenses$74,533,413CYTotalExpensesAmt
PY Revenues Less Expenses$12,339,816PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,794,417CYRevenuesLessExpensesAmt
Total Assets BOY$122,960,248TotalAssetsBOYAmt
Total Assets EOY$147,108,147TotalAssetsEOYAmt
Total Liabilities BOY$7,169,831TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,262,394TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$115,790,417NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$132,845,753NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo provide compassionate, high quality, and accessible health care and to promote a healthy community.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$69,989,644ExpenseAmt
Grant$313,800GrantAmt
Revenue$82,953,327RevenueAmt
DescGood Shepherd Health Care System (GSHCS) served 1,795 inpatients over 4,661 patient-days and 47,933 outpatients in fiscal year 2013-14, as well as 17,576 patients in our Emergency Center. Although reimbursement for services rendered is critical to the operations and stability of GSHCS, not all individuals have the ability to purchase essential medical services. In recognition of this, during FY 2013-14 GSHCS wrote off to collection $4,956,543 valued at charges foregone as bad debt. Direct charity care to our community amounted to an additional $7,411,436, valued at charges foregone. GSHCS provides care to persons covered by governmental programs at deeply discounted rates. Recognizing its mission to the community, services were provided to both Medicare and Medicaid patients. The unreimbursed value of providing care to these patients during fiscal year 2013-14 was $42,530,576, valued at charges foregone.Our Emergency Center is open around-the-clock to all community members, visitors, and travelers, without regard to one's ability to pay.Desc
Total Program Service Expenses$69,989,644TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
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 Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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 EntYes (1)BusinessRlnWithOfficerEntInd
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 EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document154IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee639EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
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 Committees0MinutesOfCommitteesInd
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 Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jan PeterBusinessNameLine1
FieldValueIRS element (for citing)
Phone5416673416PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11th StreetAddressLine1
CityHermistonCity
StateORState
ZIP Code97838ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Steve Eldrige
Chair2.000.00Yes (X)Yes (X)$0$0$0
Nancy Mabry
Vice Chair2.000.00Yes (X)Yes (X)$0$0$0
Dr Derek Earl
Secretary2.000.00Yes (X)Yes (X)$0$0$0
Tom Wamsley
Treasurer2.002.00Yes (X)Yes (X)$0$0$0
Bob Carlson
Director2.000.00Yes (X)$0$0$0
Richard Lindner
Director2.002.00Yes (X)$0$0$0
Tricia Fenley
Director2.001.00Yes (X)$0$0$0
Bill Elfering
Director2.000.00Yes (X)$0$0$0
Sue Daggett
Director2.000.00Yes (X)$0$0$0
Rachel Archer
Director2.000.00Yes (X)$0$0$0
Janet Cooley
Director2.000.00Yes (X)$0$0$0
Gabino Gispert
Director2.000.00Yes (X)$0$0$0
Dennis E Burke
President/CEO40.000.00Yes (X)$355,718$0$52,216
Jan D Peter
VP/CFO40.000.00Yes (X)$202,754$0$38,276
David T Hughes
VP/COO40.000.00Yes (X)$197,896$0$36,444
Dr Olga Stobart
Hospitalist40.000.00$349,551$0$5,907Yes (X)
Dr Thomas L Farney
Physician - Surgeon40.000.00$291,831$0$46,199Yes (X)
Dr Thomas J Holt
Physician - Urologist40.000.00$323,655$0$26,007Yes (X)
Dr Kim A Peterson
Physician - ER Doctor40.000.00$293,317$0$5,688Yes (X)
Dr Diana Edenfield
Physician - OB/GYN40.000.00$289,056$0$10,513Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,303,778TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$221,250TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K63IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
McCormack Construction Corp
422 SW 6thPendletonOR97801Construction$6,110,512
Rehab Associates
600 NW 11th St Ste E31HermistonOR97838Physical Therapy$1,281,020
Tualatin Imaging
6464 SW Boreland Rd Suite A-4TualitinOR97062Diagnostic Imaging$1,147,824
Peterson Kolberg & Associates
6969 SW HamptonPortlandOR97223Architecture$931,249
Medical Doctor Assoc Inc
PO Box 277185AtlantaGA30384Locum Doctors$472,304
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K17CntrctRcvdGreaterThan100KCnt
All Other Contributions$125,663AllOtherContributionsAmt
Total Contributions$125,663TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Net Patient Services622110$82,158,204$82,158,204
Other Supporting Revenue900099$708,759$708,759
Cafeteria900099$554,747$554,747
Daycare900099$252,967$252,967
EHR Funding900099$75,331$75,331

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,033TotalRevenueColumnAmt
Related Or Exempt Func Income$11,033RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$83,761,041TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,968,743TotalRevenueColumnAmt
Exclusion$1,968,743ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$119,592RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$119,592RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$119,592TotalRevenueColumnAmt
Exclusion$119,592ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$53,479,838SecuritiesAmt
Other$71,230OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$51,188,450SecuritiesAmt
Other$9,827OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,291,388SecuritiesAmt
Other$61,403OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,352,791TotalRevenueColumnAmt
Exclusion$2,352,791ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$88,327,830TotalRevenueColumnAmt
Related Or Exempt Func Income$82,953,327RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$5,248,840ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$313,800TotalAmt
Program Services$313,800ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$889,705TotalAmt
Management And General$889,705ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$32,180,312TotalAmt
Program Services$30,556,446ProgramServicesAmt
Management And General$1,623,866ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,336,409TotalAmt
Program Services$1,268,972ProgramServicesAmt
Management And General$67,437ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,627,148TotalAmt
Program Services$5,343,194ProgramServicesAmt
Management And General$283,954ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,941,612TotalAmt
Program Services$1,800,403ProgramServicesAmt
Management And General$141,209ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$52,917TotalAmt
Management And General$52,917ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$60,210TotalAmt
Management And General$60,210ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$40,812TotalAmt
Management And General$40,812ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,271,475TotalAmt
Program Services$8,142,243ProgramServicesAmt
Management And General$1,129,232ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$104,207TotalAmt
Program Services$97,263ProgramServicesAmt
Management And General$6,944ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,122,848TotalAmt
Program Services$8,914,086ProgramServicesAmt
Management And General$208,762ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$709,033TotalAmt
Program Services$709,033ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$301,014TotalAmt
Program Services$262,293ProgramServicesAmt
Management And General$38,721ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$202,018TotalAmt
Program Services$202,018ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$8,398TotalAmt
Program Services$8,398ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,877,753TotalAmt
Program Services$4,877,753ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$591,166TotalAmt
Program Services$591,166ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$3,415,967$3,415,967
Bad Debts$3,268,032$3,268,032
Taxes & Licenses$136,991$136,991

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$81,586TotalAmt
Program Services$81,586ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$74,533,413TotalAmt
Program Services$69,989,644ProgramServicesAmt
Management And General$4,543,769ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,985,714BOYAmt
EOY$6,122,733EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,364,329BOYAmt
EOY$12,019,309EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$13,058,734BOYAmt
EOY$13,056,234EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,976,111BOYAmt
EOY$2,233,847EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,121,830BOYAmt
EOY$1,388,640EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$98,867,750LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$48,120,503LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$44,117,207BOYAmt
EOY$50,747,247EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$48,268,655BOYAmt
EOY$63,147,316EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY-$6,573,810BOYAmt
EOY-$6,567,963EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,011,478BOYAmt
EOY$4,330,784EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$122,960,248BOYAmt
EOY$147,108,147EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,169,831BOYAmt
EOY$8,493,670EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$570,357EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$5,198,367EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,169,831BOYAmt
EOY$14,262,394EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$115,290,964BOYAmt
EOY$132,312,481EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$499,453BOYAmt
EOY$533,272EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$115,790,417BOYAmt
EOY$132,845,753EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$122,960,248BOYAmt
EOY$147,108,147EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$13,794,417ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,266,105NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$5,186PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 D IRS990ScheduleD

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,415,757OtherCostOrOtherBasisAmt
Depreciation$18,821,827DepreciationAmt
Book Value$25,593,930BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$39,535,121OtherCostOrOtherBasisAmt
Depreciation$28,046,396DepreciationAmt
Book Value$11,488,725BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,104,463OtherCostOrOtherBasisAmt
Depreciation$1,252,280DepreciationAmt
Book Value$9,852,183BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$50,747,247TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Estimated 3rd party payor settlements$280,000
Capital Lease Obligations$4,918,367
FieldValueIRS element (for citing)
Total Liability$5,198,367TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$87,979,510TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$3,266,105NetUnrealizedGainsInvstAmt
Other Revenue-$3,573,613OtherRevenueAmt
Revenue Not Reported-$307,508RevenueNotReportedAmt
Revenue Subtotal$88,287,018RevenueSubtotalAmt
Investment Expenses Not Incld$40,812InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$40,812RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$88,327,830TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$70,910,769TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$70,910,769ExpensesSubtotalAmt
Investment Expenses Not Incld2$40,812InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$3,581,832OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,622,644ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$74,533,413TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:GSHCS is organized as an Oregon non-profit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). GSHCS is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, GSHCS is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. GSHCS has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Hospital's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2011.
Part XI, Line 2d - Other Adjustments:Grants to Other Organizations recorded in Revenue on the F/S -313,800. Net Assets released from Restrictions recorded in Revenue on the F/S 8,219. Provisions for Bad Debt recorded in Revenue on the F/S -3,268,032.
Part XII, Line 4b - Other Adjustments:Grants to Other Organizations recorded in Revenue on the F/S 313,800. Provisions for Bad Debt recorded in Revenue on the F/S 3,268,032.

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 Other138.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other275.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
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)
Total Community Benefit Expns$3,651,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,651,000NetCommunityBenefitExpnsAmt
Total Expense0.05120TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,651,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,651,000NetCommunityBenefitExpnsAmt
Total Expense0.05120TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$292,442TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$110,422DirectOffsettingRevenueAmt
Net Community Benefit Expns$182,020NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,511TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,511NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$271,800TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$271,800NetCommunityBenefitExpnsAmt
Total Expense0.00380TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$574,753TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$110,422DirectOffsettingRevenueAmt
Net Community Benefit Expns$464,331NetCommunityBenefitExpnsAmt
Total Expense0.00650TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,225,753TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$110,422DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,115,331NetCommunityBenefitExpnsAmt
Total Expense0.05770TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$42,000NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$42,000NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$3,268,032BadDebtExpenseAmt
Bad Debt Expense Attributable$436,271BadDebtExpenseAttributableAmt
Reimbursed By Medicare$17,724,213ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$18,424,787CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$700,574MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
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 Line1Good Shepherd Health Care SystemBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11th StreetAddressLine1
CityHermistonCity
StateORState
ZIP Code97838ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.gshealth.orgWebsiteAddressTxt
State License055598-6StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Good Shepherd Health Care SystemBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
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
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://gshcs.net/pub/gschf-chna.pdfOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
Other Needs AddressedYes (X)OtherNeedsAddressedInd
All Needs Addressed0AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care138.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care275.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Available On RequestYes (X)AvailableOnRequestInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Lowest Negotiated RatesYes (X)LowestNegotiatedRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Good Shepherd Health Care SystemPart V, Section B, Line 3: The needs assessment was envisioned, designed, and executed by dozens of community leaders and members representing healthcare, public health, law enforcement, education, and social services. The assessment was conducted in partnership with St. Anthony Hospital in Pendleton, OR. The assessment process included regular consultation with the local Healthy Communities Coalition, a grass-roots advisory committee comprised of 35 community members of diverse background and professions.
Good Shepherd Health Care SystemPart V, Section B, Line 4: The CHNA was conducted with St. Anthony Hospital, Pendleton, OR.
Good Shepherd Health Care SystemPart V, Section B, Line 5d: The CHNA was made widely available through a newspaper article providing a synopsis of the assessment's findings, as well as public forums discussing the assessment's findings.
Good Shepherd Health Care SystemPart V, Section B, Line 6i: Implementation Strategy was also made available at the following website url: http://www.co.umatilla.or.us/health/main/Health_Improvement_Plan.pdf
Good Shepherd Health Care SystemPart V, Section B, Line 7: The following prioritized health needs were determined by CHNAs for Umatilla and Morrow counties, along with their current mitigation strategies:1. Obesity: Healthy Communities Coalition provided nutritional guideline presentations in schools and workplaces, along with ad hoc community nutrition classes.2. Mental Health: Good Shepherd will provide corporate support (friendship lease of land) for Lifeways acute inpatient mental health center in Hermiston (groundbreaking started in summer of 2014).3. Alcohol/drug addiction: Supported recruitment of additional mental health practitioners with addiction mitigation expertise. Established pain clinic with pain control specialist at Good Shepherd.4. Diabetes: Continued active diabetes education program, open to the public without restrictions on ability to pay.5. Tobacco use: Not currently addressed by Good Shepherd in deference to public health programs in place. Good Shepherd regularly offers tobacco cessation classes and support.
Good Shepherd Health Care SystemPart V, Section B, Line 14g: A summary of the FAP is distributed in unemployment offices and other areas in the community that target the eligible population. A summary is also available at local physician offices, admissions offices, and sent with billings invoices. Also, upon discharge, a patient financial representative meets with patients to discuss their ability to pay for services. Included as part of this discussion is a summary of the FAP.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
Good Shepherd Medical Group
610 NW 11th StreetHermistonOR97838Clinic
Vange John Memorial Hospice
610 NW 11th StreetHermistonOR97838Hospice
TLC Home Health
610 NW 11th StreetHermistonOR97838Home Health

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The state posts the community benefit report online.
Part I, Line 7:The charity care included in Part I, Line 7a is calculated by multiplying the ratio of cost to gross charges for the hospital by the gross uncompensated charges associated with providing charity care to its patients. The community health services, education and contributions in Part I, Lines 7e, 7f and 7i are based on actual expenses.
Part I, Ln 7 Col(f):The amount of bad debt expense removed from the denominator of the calculation on Part 1, Line 7, column f was $3,268,032.
Part II, Community Building Activities:The organization gave money to the City of Hermiston for the purpose of extending the Oxbow Trail, a walking trail. An extension of the Oxbow Trail will promote physical activity within the community.
Part III, Line 2:Bad debt on line 2 is reported at charges.
Part III, Line 3:Management considers historical write off and recovery information in determining the estimated bad debt provision. The organization estimates the amount of bad debt attributable to charity patients to be $436,271. This estimate is based on an overall charity care percentage of gross revenue.
Part III, Line 4:Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 9 of the attached audit report.
Part III, Line 8:Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules & regulations set forth by Centers for Medicare and Medicaid Services.Good Shepherd Health Care System provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the Medicare shortfall is considered a community benefit.
Part III, Line 9b:The organization's collection procedures requires a financial advisor to work with any patient who is identified as potentially being eligible for financial assistance prior to sending the account to collection. If during the course of the collection process the collection agency determines an account may be eligible for financial assistance, it is referred back to the hospital for further discussion with the patient or for write off. All further collection action is ceased.
Part VI, Line 2:Our community healthcare needs assessment process has five components that are conducted every third year:1. The ongoing collection and evaluation of community feedback from patient surveys and comment forms.2. Patient and community-member healthcare needs focus groups.3. A healthcare needs survey completed by employers and other community leaders.4. A formal telephone survey.5. A demographic study conducted by the Oregon Office of Rural Health.
Part VI, Line 3:Our financial counselors inform and educate the people we serve with respect to charity care and governmental assistance programs. All patients and responsible parties, where possible, are apprised of the availability of financial counseling services at the time and point of service. We have arranged our patient flow to maximize the convenience of visiting our financial counselors as part of the Good Shepherd treatment regime.In addition, the financial assistance policy is provided in writing to the patients upon request, and when the Hospital is able to identify a potential FAP-eligible individual upon admissions.
Part VI, Line 4:Good Shepherd Health Care System (GSHCS) is the corporate name for an organization made up of several entities, including Good Shepherd Medical Center, Vange John Memorial Hospice, TLC Home Health, Good Shepherd Medical Group, Good Shepherd Clinic Pharmacy, Good Shepherd Medical Foundation, and Good Shepherd Community Health Foundation. Good Shepherd serves a core population of almost 50,000 people in the city of Hermiston, Oregon and in 14 outlying smaller towns within a rough 50-mile radius. This population is largely rural, with agriculture dominating industrial enterprises.The average household income in Hermiston is $35,865.17.1% of residents have incomes below federal poverty guidelines.31.3% of residents identify as non-white Hispanic ethnicity, with a sizable number of Spanish-primary speakers.
Part VI, Line 5:Good Shepherd maintains open active, affiliate, and courtesy medical staffs, with privileges available to all qualified and interested physicians in the communities we serve. GSHCS is governed by a twelve-member board of trustees. The board is comprised of independent representatives of the community, with an emphasis on maintaining a true cross-section of core population communities within its membership.Our surplus funds are used to fund community health education classes, as well as funding building and equipment upgrades to maintain the highest quality healthcare for our community. Surplus funds are also applied to ongoing professional education among our clinical staff to remain current in the best practices of modern healthcare. We operate a fully-staffed 24-hour emergency room, available to the public regardless of ability to pay. Good Shepherd operates two foundations that provide funds to appropriate community groups and activities, as well as providing scholarship funds to local residents establishing or furthering healthcare-related education. We live our mission to promote a healthy community. Good Shepherd is the host and driving force behind the Good Shepherd Wellness Coalition, a grass-roots group of community leaders that identify, analyze, and address pressing healthcare issues in the community.We maintain a dialogue with the people we serve through a biweekly radio show, with an emphasis on wellness and preventative care.Good Shepherd hosts an annual Family Health and Fitness Day, with free access to healthcare professionals, free screenings, and a wealth of health and wellness information available to the public.We are active in community health-related activities, including the American Cancer Society's Relay for Life, the March of Dimes' March for Babies, and the Umatilla County Fair, where we provide health information and healthcare-related giveaways.
Part VI, Line 7, Reports Filed With StatesOR

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Good Shepherd Community Health Foundation
610 NW 11th StreetHermistonOR97838931170546501(c)(3)$250,000Annual Tithe
Blue Mountain Community College
2411 NW Carden Ave PO Box 100PendletonOR97801936033846Government$20,000Nursing Program Funding
City of Hermiston
180 NE 2ndHermistonOR97838936002182Government$42,000Oxbow Trail Extension (walking trail)
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationGrants are awarded to Good Shepherd Community Health Foundation, a related organization which is tax exempt under Section 501(c)(3). Any organization receiving an award must sign an agreement before the funds are dispursed stating the funds will be used for the stated purpose as listed in their grant application. They are also asked to submit regular reports until all funds have been spent. These reports are reviewed at the Foundation meetings of which board members who serve on both the Hospital and the Foundation Boards attend. There are no reporting requirements required to be sent to the Hospital from the other organizations listed on Schedule I.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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
Dennis E Burke
President/CEO$274,038$0$23,000$0$58,680$0$26,699$0$26,117$0$408,534$0$0$0
Jan D Peter
VP/CFO$176,758$0$17,217$0$8,779$0$14,519$0$24,406$0$241,679$0$0$0
David T Hughes
VP/COO$172,395$0$16,901$0$8,600$0$11,907$0$25,187$0$234,990$0$0$0
Dr Olga Stobart
Hospitalist$348,551$0$1,000$0$0$0$5,907$0$0$0$355,458$0$0$0
Dr Thomas L Farney
Physician - Surgeon$284,955$0$6,876$0$0$0$20,030$0$26,769$0$338,630$0$0$0
Dr Thomas J Holt
Physician - Urologist$318,861$0$4,794$0$0$0$14,981$0$11,025$0$349,661$0$0$0
Dr Kim A Peterson
Physician - ER Doctor$292,317$0$1,000$0$0$0$0$0$5,688$0$299,005$0$0$0
Dr Diana Edenfield
Physician - OB/GYN$283,949$0$5,107$0$0$0$0$0$11,113$0$300,169$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 7FormAndLineReferenceDesc
ExplanationAt the end of the fiscal year the Board determines the amount of funds that will be disbursed for bonuses based on the acheivement of specified goals. Management then determines the percentage of bonuses allocated to each level and each individual. In regards to the CEO the Hospital may pay the CEO a discretionary annual bonus in an amount to be determined by the Board or Committee based upon CEO's annual review.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Credits IncBusinessNameLine1
FieldValueIRS element (for citing)
Relationship DescriptionCompany is owned 100% by board member Nancy MabryRelationshipDescriptionTxt
Transaction$515,161TransactionAmt
TransactionCharges for collection servicesTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 8bThere are no committees with the authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11The return is reviewed by the CFO and Controller and presented on a high level to the Board of Directors. A final copy is provided to the Board before filing.
Form 990, Part VI, Section B, line 12cAll officers, directors, and key employees with conflicts are expected to disclose conflicts of interest on a voluntary basis and refrain from discussion and/or voting on related matters as necessary. These disclosures are reviewed and determined to exist or not to exist by the Board of Directors.
Form 990, Part VI, Section B, line 15aThe CEO's compensation is approved by the compensation committee of the Board of Directors based on survey information. This process is completed annually in the month of October. The compensation of other officers or key employees is determined by the CEO based on survey information. This process is completed annually on the anniversary date of the individual's hire date.
Form 990, Part VI, Section C, line 19The governing documents, conflict of interest policy and financial statements are available upon request.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 4,104,337. Management and general expenses 810,861. Fundraising expenses 0. Total expenses 4,915,198. Professional Fees: Program service expenses 3,371,791. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,371,791. Contract Labor/Temp Staff: Program service expenses 150,954. Management and general expenses 0. Fundraising expenses 0. Total expenses 150,954. Collection Expenses: Program service expenses 515,161. Management and general expenses 0. Fundraising expenses 0. Total expenses 515,161. Recruiting Fees: Program service expenses 0. Management and general expenses 318,371. Fundraising expenses 0. Total expenses 318,371.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
Good Shepherd Community Health Foundation
610 NW 11th StreetHermistonOR97838931170546FundraisingOR501(c)(3)Line 11a, IGood Shepherd Health Care SystemYes (1)
Good Shepherd Medical Foundation
610 NW 11th StreetHermistonOR97838930844485FundraisingOR501(c)(3)Line 7Good Shepherd Health Care SystemYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Good Shepherd Medical Service CorpBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1610 NW 11th StreetAddressLine1
CityHermistonCity
StateORState
ZIP Code97838ZIPCode
FieldValueIRS element (for citing)
EIN930688940EIN
Primary ActivitiesRental & Retail PharmacyPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Share Of Total Income$5,846ShareOfTotalIncomeAmt
Share Of EOY Assets$9,587,878ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
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 Org0LoansOrGuaranteesToOtherOrgInd
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 Org0RentalOfFcltsFromOthOrgInd
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 Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Good Shepherd Medical Service Corp
A$425,725book value
Good Shepherd Community Health Foundation
B$250,000book value