2014-08-12T10:04:58-05:00 2013-09-30 930623286 AKT LLP 5665 SW MEADOWS RD SUITE 200 LAKE OSWEGO OR 97035 990 2012-10-01 930823471 SALEM HEALTH SALE 5035615200 890 OAK STREET SE SALEM OR 97301 AARON R CRANE 5035615200 2014-08-07 1 JOYLYN M ANKENEY CPA P00366587 5036204489 2012 2015-11-30 17:44:51Z AARON R CRANE 890 OAK STREET SE SALEM OR 97301 69448 0 X WWW.SALEMHEALTH.ORG X 1982 OR TO SUPPORT SALEM HOSPITAL, WEST VALLEY HOSPITAL AND RELATED FOUNDATIONS. 14 12 0 14 0 0 0 0 0 0 250 252 22357 69196 22607 69448 0 0 0 0 0 0 0 0 0 36 0 36 0 22571 69448 1659323 1728771 545456 545456 1113867 1183315 TO SUPPORT SALEM HOSPITAL, WEST VALLEY HOSPITAL AND RELATED FOUNDATIONS. 0 0 69448 LEASES LAND TO SALEM HOSPITAL 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X X SALEM HEALTH 5035615150 890 OAK STREET SE SALEM OR 97301 KATHERINE KEENE 11.30 X 0 0 0 GEORGE HAPP 3.80 X 0 0 0 BRUCE CARTER MD 5.50 X 0 0 0 ALAN COSTIC 12.50 X X 0 0 0 DAVID ELMGREN MD 5.50 X 0 0 0 CHUCK HUDKINS 4.00 X 0 0 0 KENNETH SHERMAN JR 15.00 X X 0 0 0 THERESA TAAFFE 5.50 X 0 0 0 ALAN WYNN 3.60 X X 0 0 0 BONNIE DRIGGERS RN 6.30 X 0 0 0 LANE SHETTERLY 6.30 X 0 0 0 ROBERT WELLS 4.00 X 0 0 0 J BART MCMULLAN MD 4.00 X 0 0 0 ROBERT WACHTER MD 2.00 X 0 0 0 NORMAN GRUBER 40.00 X 0 908997 257423 AARON CRANE 40.00 X 0 462636 75121 0 1371633 332544 0 0 1 0 0 252 252 69196 0 69196 69196 69196 69448 0 0 69448 0 0 0 0 125306 125559 917063 917063 917063 545456 545456 71498 140693 1659323 1728771 545456 545456 545456 545456 X 1113867 1183315 1113867 1183315 1659323 1728771 69448 0 X 0 1 X 1 0 X X 0 0 0 SALEM HOSPITAL 930579722 3 1 1 1 0 WEST VALLEY HOSPITAL 431960221 3 1 1 1 0 SALEM HOSPITAL FOUNDATION 237002687 7 1 1 1 0 3 0 917063 917063 917063 INVESTMENT IN WVCH 545456 C 545456 DUE FROM SALEM HOSPITAL 140693 140693 DUE TO SALEM HOSPITAL 545456 545456 69448 0 69448 0 69448 0 0 0 0 0 X X X X X 0 1 0 0 0 0 0 1 0 NORMAN GRUBER 0 801372 0 93499 0 14126 0 216250 0 41173 0 1166420 0 0 AARON CRANE 0 436596 0 13218 0 12822 0 46132 0 28989 0 537757 0 0 PART I, LINE 4B SOME OF THE ORGANIZATION'S EMPLOYEES RECEIVE DEFERRED COMPENSATION UNDER A 457(F) NONQUALIFIED PLAN. THIS COMPENSATION IS INCLUDED IN COMPENSATION REPORTED IN PART II. THE TOTAL NONQUALIFIED PORTION OF EACH PERSONS DEFERRED COMPENSATION IS: NORMAN GRUBER $293,499 ($93,499 INCLUDED IN OTHER REPORTABLE COMPENSATION AND $200,000 INCLUDED IN DEFERRED COMPENSATION) AARON CRANE $ 28,989 (INCLUDED IN DEFERRED COMPENSATION) PART I, LINE 7 THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES, IN CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, REVIEWS CEO TOTAL COMPENSATION AND PERFORMANCE ANNUALLY. AS PART OF THE COMMITTEE'S ACTIONS, A NON-FIXED BONUS MAY BE AWARDED TO THE CEO. FORM 990, PART VI, SECTION B, LINE 11 THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE 990. IT IS THEN FORWARDED TO THE ENTIRE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS THE SECRETARY OF THE HOSPITAL SHALL SEND TO EACH PERSON WHO IS A TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE, AND TO THOSE EMPLOYEES OF THE HOSPITAL AS THE BOARD MAY DETERMINE, A COPY OF THE POLICY REGARDING CONFLICTS OF INTEREST, TOGETHER WITH A QUESTIONNAIRE INQUIRING AS TO CONFLICTS, TO BE COMPLETED AND RETURNED TO THE SECRETARY BY THE TRUSTEE, OFFICER, COMMITTEE MEMBER OR EMPLOYEE PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION AT SALEM HOSPITAL IS DESIGNED TO ALLOW THE ORGANIZATION TO RECRUIT AND RETAIN QUALIFIED SENIOR LEADERS. THE GOVERNANCE COMMITTEE OF THE SALEM HOSPITAL BOARD OF TRUSTEES, NONE OF WHOM IS A SALEM HOSPITAL EMPLOYEE, ENGAGES ONE OR MORE INDEPENDENT CONSULTANTS TO PROVIDE MARKET DATA ON EXECUTIVE COMPENSATION, INCLUDING BENEFITS, FOR THE CEO AND OTHER EXECUTIVES IN SIMILAR ROLES AT COMPARABLE ORGANIZATIONS. THIS INFORMATION IS USED BY THE GOVERNANCE COMMITTEE IN ITS DISCUSSIONS AND DECISIONS ON CEO COMPENSATION. THE CEO, IN CONJUNCTION WITH OTHER SALARY SURVEY OR PUBLIC INFORMATION AND THE INDEPENDENT CONSULTANT, ENSURES THAT EACH EXECUTIVE'S COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE ON THE HOSPITAL WEBSITE. SALEM HOSPITAL FOUNDATION 890 OAK STREET SE SALEM OR 97301 237002687 SUPPORTS SALEM HOSPITAL OR 501(C)(3) 7 N/A 1 SALEM HOSPITAL AUXILIARY 890 OAK STREET SE SALEM OR 97301 931081113 SUPPORTS SALEM HOSPITAL OR 501(C)(3) 9 N/A 0 SALEM HOSPITAL 890 OAK STREET SE SALEM OR 97301 930579722 HOSPITAL OR 501(C)(3) 3 SALEM HEALTH 1 WEST VALLEY HOSPITAL 525 SOUTHEAST WASHINGTON STREET DALLAS OR 97338 431960221 HOSPITAL OR 501(C)(3) 3 SALEM HEALTH 1 WEST VALLEY HOSPITAL FOUNDATION 525 SOUTHEAST WASHINGTON STREET DALLAS OR 97338 931298564 SUPPORTS WEST VALLEY HOSPITAL OR 501(C)(3) 11 TYPE 1 N/A 1 WILLAMETTE VALLEY INSURANCE COMPANY 745 FORT STREET HONOLULU HI 96813 201836190 CAPTIVE INSURANCE HI 501(C)(3) 11 TYPE 1 SALEM HEALTH 1 WILLAMETTE VALLEY PROFESSIONAL SERVICES 890 OAK STREET SE SALEM OR 97301 753175249 BILLING SERVICE FOR PROFESSIONAL FEES OR 501(C)(3) 3 SALEM HEALTH 1 OREGON COMMUNITY IMAGING LLC 2925 RYAN DR SE SALEM OR 97301 202683062 MEDICAL IMAGING COOPERATIVE OR SALEM HEALTH RELATED 28413 42460 0 1 0.50000 1 0 0 1 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0